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General NPI Number Information
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NPI Number | 1861775660
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Entity Type | Organization
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Legal Business Name | STAMFORD NATUROPATHIC & ACUPUNCTURE, LLC
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Dates
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Enumeration Date | 09/28/2011
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Last Update Date | 09/28/2011
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Provider Practice Location Address
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Address Line | 66 GLENBROOK RD SUITE 300
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City | STAMFORD
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State | CT
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Zip | 06902-8402
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Country | US
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Telephone | 203-623-5796
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Fax |
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Provider Business Mailing Address
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Address Line | 1 STRAWBERRY HILL CT APT 8C
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City | STAMFORD
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State | CT
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Zip | 06902-2523
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Country | US
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Telephone | 203-623-5796
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Fax |
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Authorized Official
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Title or Position | MANAGER/OWNER
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Name | DR. MINNA KIM
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Credential | N.D.
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Telephone | 203-623-5796
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | 000443
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License Number State | CT
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