Provider Demographics
NPI:1003553355
Name:ALBANY ACUPUNCTURE CLINIC, INC
Entity Type:Organization
Organization Name:ALBANY ACUPUNCTURE CLINIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWENDIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DA
Authorized Official - Phone:541-928-2171
Mailing Address - Street 1:PO BOX 311
Mailing Address - Street 2:
Mailing Address - City:TANGENT
Mailing Address - State:OR
Mailing Address - Zip Code:97389-0311
Mailing Address - Country:US
Mailing Address - Phone:541-928-2171
Mailing Address - Fax:541-981-2113
Practice Address - Street 1:724 LYON ST SW
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:OR
Practice Address - Zip Code:97321-2921
Practice Address - Country:US
Practice Address - Phone:541-928-2171
Practice Address - Fax:541-981-2113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty