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General NPI Number Information
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NPI Number | 1902365158
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Entity Type | Organization
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Legal Business Name | ACUPUNCTURE PAIN RELIEF CLINIC LLC
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Dates
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Enumeration Date | 03/18/2019
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Last Update Date | 12/11/2019
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Provider Practice Location Address
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Address Line | 827 N BLOODWORTH ST STE A
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City | RALEIGH
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State | NC
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Zip | 27604-1231
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Country | US
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Telephone | 919-283-8784
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Fax | 855-854-7098
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Provider Business Mailing Address
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Address Line | 827 N BLOODWORTH ST STE A
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City | RALEIGH
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State | NC
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Zip | 27604-1231
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Country | US
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Telephone | 919-283-8784
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Fax | 855-854-7098
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Authorized Official
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Title or Position | OWNER/MEMBER
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Name | JACOB LEE
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Credential | LAC
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Telephone | 919-283-8784
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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 |
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License Number State |
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