MEDICARE: INNER PEACE ACUPUNCTURE & WELLNESS INC

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	:	1225688690
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNER PEACE ACUPUNCTURE & WELLNESS INC

Provider Business Mailing Address
First Line	:	741 KENILWORTH AVE STE 204
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28204-3873
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	741 KENILWORTH AVE STE 204
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28204-3873
Country	:	US
Telephone Number	:	704-307-7821
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ADRIENNE WEI-DREHMEL
Credential	:	MSOM
Telephone Number	:	704-915-1719

Provider Enumeration Date	:	09/17/2019
Last Update Date	:	09/17/2019

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