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General NPI Number Information
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NPI Number | 1962934455
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Entity Type | Organization
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Legal Business Name | FOUNDATIONS OF WELLNESS INC
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Dates
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Enumeration Date | 04/03/2017
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Last Update Date | 07/03/2024
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Provider Practice Location Address
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Address Line | 3905 CORBIN PL
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City | BOWIE
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State | MD
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Zip | 20715-1653
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Country | US
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Telephone | 443-333-6024
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Fax |
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Provider Business Mailing Address
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Address Line | 3905 CORBIN PL
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City | BOWIE
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State | MD
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Zip | 20715-1653
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Country | US
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Telephone | 443-333-6024
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TERESA THOMPSON
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Credential | L.AC.
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Telephone | 443-333-6024
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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 | U02257
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License Number State | MD
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