Provider Demographics
NPI:1073264149
Name:A CHANGE OF HEALTH ACUPUNCTURE CLINIC
Entity Type:Organization
Organization Name:A CHANGE OF HEALTH ACUPUNCTURE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:YELLE
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:810-835-5616
Mailing Address - Street 1:4001 WALLI STRASSE DR
Mailing Address - Street 2:
Mailing Address - City:BURTON
Mailing Address - State:MI
Mailing Address - Zip Code:48509-1729
Mailing Address - Country:US
Mailing Address - Phone:810-715-7746
Mailing Address - Fax:
Practice Address - Street 1:4001 WALLI STRASSE DR
Practice Address - Street 2:
Practice Address - City:BURTON
Practice Address - State:MI
Practice Address - Zip Code:48509-1729
Practice Address - Country:US
Practice Address - Phone:810-715-7746
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-11
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty