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General NPI Number Information
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NPI Number | 1740664754
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Entity Type | Organization
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Legal Business Name | OCEANSIDE ACUPUNCTURE
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Dates
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Enumeration Date | 07/20/2015
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Last Update Date | 07/20/2015
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Provider Practice Location Address
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Address Line | 2620 MANATEE AVE W STE A
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City | BRADENTON
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State | FL
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Zip | 34205-4944
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Country | US
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Telephone | 941-993-9649
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Fax |
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Provider Business Mailing Address
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Address Line | 1223 76TH ST NW
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City | BRADENTON
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State | FL
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Zip | 34209-1034
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JANE E PASIENZA
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Credential | AP
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Telephone | 941-993-9649
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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 | AP3039
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License Number State | FL
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