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General NPI Number Information
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NPI Number | 1730410580
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Entity Type | Organization
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Legal Business Name | ACU WELL ACUPUNCTURE & INTEGRATIVE NEDICINE
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Dates
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Enumeration Date | 01/19/2010
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Last Update Date | 01/19/2010
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Provider Practice Location Address
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Address Line | 141 AIRPORT RD
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City | WARWICK
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State | RI
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Zip | 02889-1032
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Country | US
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Telephone | 401-738-9355
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Fax | 401-679-0038
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Provider Business Mailing Address
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Address Line | 141 AIRPORT RD
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City | WARWICK
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State | RI
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Zip | 02889-1032
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Country | US
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Telephone | 401-738-9355
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Fax | 401-679-0038
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALEX TATEVIAN
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Credential | DA
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Telephone | 401-738-9355
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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 | 064
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License Number State | RI
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