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General NPI Number Information
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NPI Number | 1710380225
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Entity Type | Organization
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Legal Business Name | RELIEF ACUPUNCTURE LLC
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Dates
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Enumeration Date | 09/29/2014
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Last Update Date | 09/29/2014
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Provider Practice Location Address
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Address Line | W62N265 WASHINGTON AVE
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City | CEDARBURG
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State | WI
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Zip | 53012-2736
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Country | US
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Telephone | 262-872-0037
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Fax |
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Provider Business Mailing Address
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Address Line | W192S6560 HILLENDALE DR
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City | MUSKEGO
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State | WI
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Zip | 53150-9688
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Country | US
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Telephone | 619-818-7674
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEPHANIE JAKUBIAK
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Credential | L.AC
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Telephone | 619-818-7674
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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 | 835-55
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License Number State | WI
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