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General NPI Number Information
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NPI Number | 1962870667
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Entity Type | Organization
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Legal Business Name | MEDICAL MASSAGE & ACUPUNCTURE, P.S.
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Dates
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Enumeration Date | 09/11/2015
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Last Update Date | 11/05/2015
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Provider Practice Location Address
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Address Line | 2530 NE KRESKY AVE SUITE B
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City | CHEHALIS
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State | WA
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Zip | 98532-2406
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Country | US
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Telephone | 360-996-4778
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Fax | 360-996-4783
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Provider Business Mailing Address
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Address Line | 2980 N BEVERLY GLEN CIR SUITE 100
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City | LOS ANGELES
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State | CA
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Zip | 90077-1726
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Country | US
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Telephone | 310-943-4180
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | TIMOTHY KUHLMAN
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Credential | ND
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Telephone | 360-996-4778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | NT00000843
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License Number State | WA
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