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General NPI Number Information
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NPI Number | 1881192946
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Entity Type | Organization
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Legal Business Name | PEACHTREE CITY ACUPUNCTURE, INC.
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Dates
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Enumeration Date | 01/24/2018
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Last Update Date | 10/07/2021
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Provider Practice Location Address
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Address Line | 4000 SHAKERAG HL STE 300
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-4047
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Country | US
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Telephone | 770-756-1979
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Fax | 855-393-9876
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Provider Business Mailing Address
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Address Line | 4000 SHAKERAG HL STE 300
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-4047
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Country | US
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Telephone | 770-756-1979
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Fax | 855-393-9876
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Authorized Official
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Title or Position | CO-OWNER
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Name | HARRIS SAMUEL FRANK
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Credential |
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Telephone | 770-756-1979
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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 | 322
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License Number State | GA
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