Provider Demographics
NPI:1245773944
Name:OCEANA ACUPUNCTURE & WELLNESS CLINIC
Entity Type:Organization
Organization Name:OCEANA ACUPUNCTURE & WELLNESS CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HACKMANN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:910-679-8818
Mailing Address - Street 1:5613 MAXWELL PL
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28409-2966
Mailing Address - Country:US
Mailing Address - Phone:910-679-8818
Mailing Address - Fax:
Practice Address - Street 1:2030 EASTWOOD RD # SUITLE3
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-7212
Practice Address - Country:US
Practice Address - Phone:910-679-8818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-29
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLIC 911171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty