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General NPI Number Information
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NPI Number | 1750815296
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE ACUPUNCTURE & HEALING CENTER
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Dates
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Enumeration Date | 04/11/2017
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Last Update Date | 04/11/2017
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Provider Practice Location Address
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Address Line | 317 N FLORIDA AVE
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City | DELAND
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State | FL
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Zip | 32720-3483
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Country | US
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Telephone | 386-215-1387
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Fax |
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Provider Business Mailing Address
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Address Line | 317 N FLORIDA AVE
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City | DELAND
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State | FL
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Zip | 32720-3483
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Country | US
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Telephone | 386-215-1387
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Fax |
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Authorized Official
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Title or Position | DIPLOMATE OF ORIENTAL MEDICINE
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Name | TERESA TOLEDO
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Credential | D.O.M, L.AP, R.N
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Telephone | 386-215-1387
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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 | 3330
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License Number State | FL
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