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General NPI Number Information
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NPI Number | 1891237343
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Entity Type | Organization
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Legal Business Name | GET WELL ACUPUNCTURE
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Dates
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Enumeration Date | 11/15/2016
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Last Update Date | 11/15/2016
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Provider Practice Location Address
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Address Line | 890 TOWN CENTER DR B-ANYTIME FITNESS
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City | LA CANADA
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State | CA
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Zip | 91011-1653
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Country | US
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Telephone | 626-415-8616
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Fax |
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Provider Business Mailing Address
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Address Line | 508 S MERIDIAN AVE
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City | ALHAMBRA
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State | CA
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Zip | 91801-3046
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Country | US
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Telephone | 626-833-4603
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | MS. GINA LYNN HORTON
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Credential | LAC
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Telephone | 626-833-4603
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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 | AC17415
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License Number State | CA
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