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General NPI Number Information
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NPI Number | 1851662555
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Entity Type | Organization
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Legal Business Name | AXIS ACUPUNCTURE & HEALING ARTS
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Dates
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Enumeration Date | 01/26/2012
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Last Update Date | 02/03/2012
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Provider Practice Location Address
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Address Line | 1213 LOCUST ST
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City | PHILADELPHIA
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State | PA
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Zip | 19107-5409
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Country | US
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Telephone | 505-469-1239
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Fax |
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Provider Business Mailing Address
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Address Line | 3050 ALMOND ST
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City | PHILADELPHIA
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State | PA
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Zip | 19134-5028
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Country | US
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Telephone | 505-469-1239
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Fax |
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Authorized Official
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Title or Position | ORIENTAL MEDICINE PRACTITIONER
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Name | MISS JULIA PROCTOR
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Credential |
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Telephone | 505-469-1239
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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 | OM000129
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License Number State | PA
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