Provider Demographics
NPI:1073650032
Name:KIMBERLY BONDE ACUPUNCTURE, INC.
Entity Type:Organization
Organization Name:KIMBERLY BONDE ACUPUNCTURE, INC.
Other - Org Name:INTOWN ACUPUNCTURE, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BONDE
Authorized Official - Suffix:
Authorized Official - Credentials:LIC AC
Authorized Official - Phone:404-378-1543
Mailing Address - Street 1:340 MEAD RD.
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030
Mailing Address - Country:US
Mailing Address - Phone:404-378-1543
Mailing Address - Fax:
Practice Address - Street 1:340 MEAD RD.
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030
Practice Address - Country:US
Practice Address - Phone:404-378-1543
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA#19171100000X
GA00019171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty