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General NPI Number Information
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NPI Number | 1922405513
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Entity Type | Organization
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Legal Business Name | ACUOM LLC
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Dates
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Enumeration Date | 11/25/2014
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Last Update Date | 11/25/2014
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Provider Practice Location Address
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Address Line | 290 W PALMETTO PARK RD UNIT # 412
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City | BOCA RATON
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State | FL
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Zip | 33432-3768
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Country | US
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Telephone | 954-650-0542
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Fax |
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Provider Business Mailing Address
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Address Line | 290 W PALMETTO PARK RD UNIT # 412
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City | BOCA RATON
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State | FL
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Zip | 33432-3768
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Country | US
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Telephone | 954-650-0542
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. WILLIAM J LARZELERE
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Credential | OMD
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Telephone | 954-650-0542
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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 | AP 3026
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License Number State | FL
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