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General NPI Number Information
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NPI Number | 1720419989
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Entity Type | Organization
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Legal Business Name | WEST COAST ACUPUNCTURE & ORIENTAL MEDICINE, LLC
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Dates
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Enumeration Date | 12/12/2013
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Last Update Date | 02/03/2015
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Provider Practice Location Address
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Address Line | 5475 GOLDEN GATE PKWY UNIT 4
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City | NAPLES
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State | FL
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Zip | 34116-7529
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Country | US
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Telephone | 239-348-0742
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Fax | 941-564-2295
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Provider Business Mailing Address
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Address Line | 5475 GOLDEN GATE PKWY UNIT 4
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City | NAPLES
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State | FL
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Zip | 34116-7529
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Country | US
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Telephone | 239-348-0742
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Fax | 941-564-2295
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Authorized Official
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Title or Position | OWNER
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Name | LUCIENNE S. LALLEMAND
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Credential | AP
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Telephone | 239-348-0742
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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 | AP 3294
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License Number State | FL
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