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NPI Code Detail

MEDICARE: HE ACPUNCTURE & HERBAL MEDICINE, LLC

MEDICARE: HE ACPUNCTURE & HERBAL MEDICINE, 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
1171100000XAcupuncturist786-55WI

General Provider Information

NPI Number : 1336481399
Entity Type Code : Organization
Provider Name (Legal Business Name) : HE ACPUNCTURE & HERBAL MEDICINE, LLC
Provider Business Mailing Address
First Line : 3632 W LAKEFIELD DR
Second Line :
City : MILWAUKEE
State : WI
Zip : 53215-4135
Country : US
Telephone Number : 414-630-7229
Fax Number :
Provider Business Practice Location Address
First Line : 3632 W LAKEFIELD DR
Second Line :
City : MILWAUKEE
State : WI
Zip : 53215-4135
Country : US
Telephone Number : 414-630-7229
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MRS. HEATHER L ELDRIDGE
Credential : C.AC, MSOM
Telephone Number : 414-630-7229
Provider Enumeration Date : 03/18/2013
Last Update Date : 03/18/2013

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Directions to “HE ACPUNCTURE & HERBAL MEDICINE, LLC ” Practice Location

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