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General NPI Number Information
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NPI Number | 1710230966
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Entity Type | Organization
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Legal Business Name | AMPM ACUPUNCTURE
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Dates
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Enumeration Date | 10/24/2012
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Last Update Date | 10/25/2012
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Provider Practice Location Address
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Address Line | 12537 WALSINGHAM RD
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City | LARGO
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State | FL
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Zip | 33774-3616
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Country | US
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Telephone | 727-410-7698
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 351
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City | INDIAN ROCKS BEACH
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State | FL
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Zip | 33785-0351
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Country | US
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Telephone | 727-410-7698
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MISS MICHELE COLLEEN MCCRANIE
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Credential | A.P.
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Telephone | 727-410-7698
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP3003
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License Number State | FL
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