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General NPI Number Information
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NPI Number | 1871731372
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Entity Type | Organization
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Legal Business Name | AESTHETIC ACUPUNCTURE CLINIC
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Dates
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Enumeration Date | 01/22/2009
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Last Update Date | 01/22/2009
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Provider Practice Location Address
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Address Line | 7758 WALLACE RD SUITE X
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City | ORLANDO
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State | FL
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Zip | 32819-7219
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Country | US
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Telephone | 407-355-9990
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Fax | 407-355-9844
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Provider Business Mailing Address
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Address Line | 7758 WALLACE RD SUITE X
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City | ORLANDO
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State | FL
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Zip | 32819-7219
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Country | US
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Telephone | 407-355-9990
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Fax | 407-355-9844
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHELLE O'SHAUGHNESSY
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Credential | D.O.M.
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Telephone | 407-355-9990
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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 | AP3223
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License Number State | FL
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