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General NPI Number Information
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NPI Number | 1861696957
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Entity Type | Individual
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Provider Name | SAINLOUITANE THEUS D.O.M
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Gender | Female
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Dates
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Enumeration Date | 06/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2801 ORANGE AVE
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City | FORT PIERCE
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State | FL
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Zip | 34947-3607
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Country | US
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Telephone | 561-302-7402
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Fax | 954-429-1063
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Provider Business Mailing Address
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Address Line | 3513 PALAIS TER
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City | WELLINGTON
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State | FL
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Zip | 33467-8063
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Country | US
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Telephone | 561-302-7402
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Fax | 954-429-1063
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | AP 2293
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License Number State | FL
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