Provider Demographics
NPI:1104367341
Name:DEVOTED DAWN ACUPUNCTURE, LLC
Entity Type:Organization
Organization Name:DEVOTED DAWN ACUPUNCTURE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF ORIENTAL MEDICINE
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, DOM
Authorized Official - Phone:910-725-0727
Mailing Address - Street 1:780 NW BROAD ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SOUTHERN PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28387-4102
Mailing Address - Country:US
Mailing Address - Phone:910-725-0727
Mailing Address - Fax:910-725-0728
Practice Address - Street 1:780 NW BROAD ST
Practice Address - Street 2:SUITE 300
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-4102
Practice Address - Country:US
Practice Address - Phone:910-725-0727
Practice Address - Fax:910-725-0728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-20
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC907171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty