Provider Demographics
NPI:1114237641
Name:HAHN, KELLY H (ACP)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:H
Last Name:HAHN
Suffix:
Gender:F
Credentials:ACP
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Mailing Address - Street 1:25 TERHUNE AVE
Mailing Address - Street 2:LOTUS AFFORDABLE ACUPUNCTURE, LLC.
Mailing Address - City:LODI
Mailing Address - State:NJ
Mailing Address - Zip Code:07644-2153
Mailing Address - Country:US
Mailing Address - Phone:201-688-6633
Mailing Address - Fax:973-272-6046
Practice Address - Street 1:25 TERHUNE AVE
Practice Address - Street 2:LOTUS AFFORDABLE ACUPUNCTURE, LLC.
Practice Address - City:LODI
Practice Address - State:NJ
Practice Address - Zip Code:07644-2153
Practice Address - Country:US
Practice Address - Phone:201-688-6633
Practice Address - Fax:973-272-6046
Is Sole Proprietor?:No
Enumeration Date:2010-10-18
Last Update Date:2012-04-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00073500171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist