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General NPI Number Information
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NPI Number | 1811447600
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Entity Type | Organization
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Legal Business Name | LAUREN BERENDT LAC
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Dates
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Enumeration Date | 10/05/2016
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Last Update Date | 10/05/2016
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Provider Practice Location Address
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Address Line | 7379 MYRNA BLVD
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City | KENT
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State | OH
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Zip | 44240-6317
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Country | US
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Telephone | 330-810-1760
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Fax |
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Provider Business Mailing Address
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Address Line | 1951 STATE ROUTE 59 STE D
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City | KENT
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State | OH
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Zip | 44240-8128
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | LAUREN BERENDT
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Credential | L.AC.
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Telephone | 330-810-1760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 65.000274
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License Number State | OH
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