Provider Demographics
NPI:1225461379
Name:ON POINT ACUPUNCTURE, LLC
Entity Type:Organization
Organization Name:ON POINT ACUPUNCTURE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:AMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:HUCKABONE
Authorized Official - Suffix:
Authorized Official - Credentials:LIC AC
Authorized Official - Phone:860-598-0459
Mailing Address - Street 1:12 COULTER ST
Mailing Address - Street 2:
Mailing Address - City:OLD SAYBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06475-2313
Mailing Address - Country:US
Mailing Address - Phone:860-598-0459
Mailing Address - Fax:
Practice Address - Street 1:12 COULTER ST
Practice Address - Street 2:
Practice Address - City:OLD SAYBROOK
Practice Address - State:CT
Practice Address - Zip Code:06475-2313
Practice Address - Country:US
Practice Address - Phone:860-598-0459
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT528171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty