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General NPI Number Information
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NPI Number | 1922495969
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Entity Type | Organization
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Legal Business Name | STILL QUIET PLACE WELLNESS
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Dates
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Enumeration Date | 04/16/2015
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Last Update Date | 04/16/2015
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Provider Practice Location Address
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Address Line | 2886 RINGLING BLVD
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City | SARASOTA
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State | FL
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Zip | 34237-5331
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Country | US
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Telephone | 941-681-4564
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Fax |
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Provider Business Mailing Address
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Address Line | 2702 JEFFERSON CIR
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City | SARASOTA
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State | FL
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Zip | 34239-4039
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURE PHYSICIAN
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Name | AMY UPHOLZ
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Credential | AP
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Telephone | 941-681-4564
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | AP3344
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License Number State | FL
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