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General NPI Number Information
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NPI Number | 1750106456
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Entity Type | Organization
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Legal Business Name | CAROLINA FAMILY ACUPUNCTURE LLC
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 1218 JOHN B WHITE SR BLVD STE E
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City | SPARTANBURG
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State | SC
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Zip | 29306-3920
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Country | US
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Telephone | 864-309-0200
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Fax |
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Provider Business Mailing Address
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Address Line | 1218 JOHN B WHITE SR BLVD STE E
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City | SPARTANBURG
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State | SC
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Zip | 29306-3920
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Country | US
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Telephone | 530-809-6712
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Fax |
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Authorized Official
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Title or Position | OWNER/MEMBER
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Name | DAWN SULLIVAN GARRISON
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Credential | L.AC, DAOM
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Telephone | 831-466-6850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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