Provider Demographics
NPI:1245782366
Name:CROSS KEYS ACUPUNCTURE AND HEALING ARTS
Entity Type:Organization
Organization Name:CROSS KEYS ACUPUNCTURE AND HEALING ARTS
Other - Org Name:CROSS KEYS ACUPUNCTURE
Other - Org Type:Other Name
Authorized Official - Title/Position:NCCAOM ACUPUNCTURIST
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:S
Authorized Official - Last Name:OLIVA
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, MAC
Authorized Official - Phone:443-990-1165
Mailing Address - Street 1:2 HAMILL RD
Mailing Address - Street 2:SUITE 214 EAST QUADRANGLE
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21210-1806
Mailing Address - Country:US
Mailing Address - Phone:443-990-1165
Mailing Address - Fax:443-708-0898
Practice Address - Street 1:1752 E LOMBARD ST
Practice Address - Street 2:#2
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21231-1829
Practice Address - Country:US
Practice Address - Phone:443-990-1165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-25
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01113171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty