Provider Demographics
NPI:1093956641
Name:HEALTHSPRING ACUPUNCTURE INC.
Entity Type:Organization
Organization Name:HEALTHSPRING ACUPUNCTURE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DALE
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:707-824-8381
Mailing Address - Street 1:PO BOX 2118
Mailing Address - Street 2:
Mailing Address - City:SEBASTOPOL
Mailing Address - State:CA
Mailing Address - Zip Code:95473-2118
Mailing Address - Country:US
Mailing Address - Phone:707-824-8381
Mailing Address - Fax:707-824-8431
Practice Address - Street 1:1205 GRAVENSTEIN HWY S
Practice Address - Street 2:
Practice Address - City:SEBASTOPOL
Practice Address - State:CA
Practice Address - Zip Code:95472-4851
Practice Address - Country:US
Practice Address - Phone:707-824-8381
Practice Address - Fax:707-824-8431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-11
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC4210171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty