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General NPI Number Information
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NPI Number | 1770877839
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Entity Type | Organization
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Legal Business Name | LIFETREE ACUPUNCTURE AND HERBAL MEDICINE
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Dates
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Enumeration Date | 06/07/2011
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Last Update Date | 06/07/2011
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Provider Practice Location Address
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Address Line | 2580 N UNIVERSITY DR
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City | SUNRISE
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State | FL
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Zip | 33322-3055
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Country | US
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Telephone | 305-772-4524
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Fax |
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Provider Business Mailing Address
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Address Line | 12920 SW 83RD CT
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City | MIAMI
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State | FL
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Zip | 33156-5927
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Country | US
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Telephone | 305-256-9424
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JUNGHYUN PARK
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Credential |
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Telephone | 305-772-4524
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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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