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General NPI Number Information
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NPI Number | 1750136859
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Entity Type | Organization
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Legal Business Name | LIFE TEMPO ACUPUNCTURE
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Dates
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Enumeration Date | 04/22/2024
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Last Update Date | 04/22/2024
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Provider Practice Location Address
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Address Line | 2324 NE 53RD ST
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-3212
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Country | US
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Telephone | 954-530-2379
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Fax | 954-769-2379
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Provider Business Mailing Address
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Address Line | 2324 NE 53RD ST
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City | FORT LAUDERDALE
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State | FL
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Zip | 33308-3212
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Country | US
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Telephone | 954-530-2379
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Fax | 954-769-2379
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Authorized Official
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Title or Position | OWNER
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Name | CHRSITOPHER PETRIE
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Credential | AP
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Telephone | 954-530-2379
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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 |
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License Number State |
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