MEDICARE: TRANQUILITY ACUPUNCTURE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist

General Provider Information

NPI Number	:	1013491893
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRANQUILITY ACUPUNCTURE, LLC

Provider Business Mailing Address
First Line	:	6363 LOWRIDGE DR APT M
Second Line	:
City	:	CANAL WINCHESTER
State	:	OH
Zip	:	43110-9482
Country	:	US
Telephone Number	:	937-561-0832
Fax Number	:

Provider Business Practice Location Address
First Line	:	232 N MAIN ST STE 1B
Second Line	:
City	:	MARYSVILLE
State	:	OH
Zip	:	43040-1181
Country	:	US
Telephone Number	:	937-561-0832
Fax Number	:

Authorized Official
Title or Position	:	SOLE OWNER/L.AC
Name	:	REBECA A TRUMAN
Credential	:
Telephone Number	:	937-561-0832

Provider Enumeration Date	:	09/18/2018
Last Update Date	:	09/18/2018

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Directions to “TRANQUILITY ACUPUNCTURE, LLC ” Practice Location

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