Provider Demographics
NPI:1013389717
Name:WV ACUPUNCTURE, INC.
Entity Type:Organization
Organization Name:WV ACUPUNCTURE, INC.
Other - Org Name:JASON TROMBLEY, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:TROMBLEY
Authorized Official - Suffix:
Authorized Official - Credentials:AP, LMT
Authorized Official - Phone:304-282-5553
Mailing Address - Street 1:990 FAIRMONT RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26501-2249
Mailing Address - Country:US
Mailing Address - Phone:304-282-5553
Mailing Address - Fax:
Practice Address - Street 1:990 FAIRMONT RD
Practice Address - Street 2:SUITE B
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26501-2249
Practice Address - Country:US
Practice Address - Phone:304-282-5553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-21
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV96212171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty