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General NPI Number Information
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NPI Number | 1740369172
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Entity Type | Organization
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Legal Business Name | GARDEN OF WELLNESS ACUPUNCTURE
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Dates
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Enumeration Date | 11/05/2006
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Last Update Date | 06/13/2008
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Provider Practice Location Address
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Address Line | 1276 N PALM CANYON DR SUITE 208
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City | PALM SPRINGS
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State | CA
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Zip | 92262-4411
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Country | US
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Telephone | 760-325-7776
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Fax |
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Provider Business Mailing Address
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Address Line | 1276 N PALM CANYON DR SUITE 208
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City | PALM SPRINGS
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State | CA
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Zip | 92262-4411
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Country | US
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Telephone | 760-325-7776
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Fax | 760-325-7715
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Authorized Official
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Title or Position | LICENSED ACUPUNCTURIST
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Name | PETRA BEATRICE MONCRIEF
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Credential | MTOM
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Telephone | 760-325-7776
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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 | AC8945
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License Number State | CA
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