1457827669 NPI number — WHOLISTIC ACUPUNCTURE LLC

Table of content: ANNE PELLETIER CAMERON MD (NPI 1629267042)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457827669 NPI number — WHOLISTIC ACUPUNCTURE LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WHOLISTIC ACUPUNCTURE LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457827669
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/16/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6463 PROPRIETORS RD STE 101
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WORTHINGTON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43085-3263
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-888-9303
Provider Business Mailing Address Fax Number:
833-254-2633

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6463 PROPRIETORS RD STE 101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WORTHINGTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43085-3263
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-888-9303
Provider Business Practice Location Address Fax Number:
833-254-2633
Provider Enumeration Date:
10/16/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MILLER
Authorized Official First Name:
DANIEL
Authorized Official Middle Name:
Authorized Official Title or Position:
ACUPUNCTURIST
Authorized Official Telephone Number:
614-888-9303

Provider Taxonomy Codes

  • Taxonomy code: 171100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)