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General NPI Number Information
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NPI Number | 1982111274
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Entity Type | Organization
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Legal Business Name | WILLPOWER HEALTH AND FITNESS
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Dates
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Enumeration Date | 01/08/2018
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Last Update Date | 01/08/2018
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Provider Practice Location Address
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Address Line | 332 19TH ST
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City | OAKLAND
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State | CA
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Zip | 94612-3406
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Country | US
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Telephone | 510-502-5261
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Fax |
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Provider Business Mailing Address
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Address Line | 212 FRISBIE ST
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City | OAKLAND
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State | CA
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Zip | 94611-5517
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Country | US
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Telephone | 510-502-5261
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | WILLIAM WARE
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Credential | LAC
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Telephone | 510-502-5261
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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 | 17495
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License Number State | CA
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