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General NPI Number Information
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NPI Number | 1942607973
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Entity Type | Organization
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Legal Business Name | CADUCEUS ACUPUNTURE MEDICAL CENTER LLC
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Dates
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Enumeration Date | 11/19/2014
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Last Update Date | 11/20/2014
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Provider Practice Location Address
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Address Line | 1195 N MILITARY TRL SUITE 5 B
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-6058
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Country | US
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Telephone | 561-557-2138
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Fax | 561-215-5059
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Provider Business Mailing Address
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Address Line | 1195 N MILITARY TRL SUITE 5 B
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-6058
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Country | US
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Telephone | 561-557-2138
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Fax | 561-215-5059
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Authorized Official
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Title or Position | PRESIDENT/OWNER/PROVIDER
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Name | KESNEL THEUS
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Credential | AP
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Telephone | 561-557-2138
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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 | AP2382
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License Number State | FL
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