Provider Demographics
NPI:1003500166
Name:ACUMASSAGE THERAPY CENTER A PROFESSIONAL ACUPUNCTURE CORPORATION
Entity Type:Organization
Organization Name:ACUMASSAGE THERAPY CENTER A PROFESSIONAL ACUPUNCTURE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ACUPUNCTURIST
Authorized Official - Prefix:MR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:OLOW
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:619-405-5282
Mailing Address - Street 1:1901 CLOVER WAY
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92026-1007
Mailing Address - Country:US
Mailing Address - Phone:619-405-5282
Mailing Address - Fax:619-872-0722
Practice Address - Street 1:311 F ST STE 101
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-2601
Practice Address - Country:US
Practice Address - Phone:619-405-5282
Practice Address - Fax:619-872-0722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty