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General NPI Number Information
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NPI Number | 1932860772
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Entity Type | Organization
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Legal Business Name | SPIRIT ROSE WELLNESS LLC
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Dates
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Enumeration Date | 01/04/2022
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Last Update Date | 06/23/2022
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Provider Practice Location Address
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Address Line | 138 CHARLOTTE ST UNIT 212
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City | ASHEVILLE
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State | NC
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Zip | 28801-1981
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Country | US
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Telephone | 828-242-2489
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Fax |
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Provider Business Mailing Address
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Address Line | 219 GREENVILLE AVE UNIT 203
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City | ARDEN
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State | NC
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Zip | 28704-1067
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Country | US
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Telephone | 828-242-2489
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | JAIME RIDGWAY
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Credential | LAC
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Telephone | 828-242-2489
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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