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NPI 1770208464

NPI 1770208464 : HOLISTIC HEALING ACUPUNCTURE PC : BOISE, ID

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General NPI Number Information
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    NPI Number           |    1770208464
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    Entity Type          |    Organization 
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    Legal Business Name  |    HOLISTIC HEALING ACUPUNCTURE PC 
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Dates
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    Enumeration Date     |    10/05/2022
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    Last Update Date     |    10/14/2025
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Provider Practice Location Address
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    Address Line         |    921 S ORCHARD ST STE 101 
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    City                 |    BOISE
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    State                |    ID
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    Zip                  |    83705-1916
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    Country              |    US
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    Telephone            |    208-310-8887
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2008 W SUNRISE RIM RD 
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    City                 |    BOISE
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    State                |    ID
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    Zip                  |    83705-5142
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    Country              |    US
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    Telephone            |    208-310-8887
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    Fax                  |    
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Authorized Official
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    Title or Position    |    LICENSED ACUPUNCTURIST
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    Name                 |    MS. MIRIAM BAILA HAYMAN 
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    Credential           |    L.AC. MSAOM
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    Telephone            |    208-310-8887
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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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