Provider Demographics
NPI:1245783232
Name:PRACTICAL ACUPUNCTURE
Entity Type:Organization
Organization Name:PRACTICAL ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:LENNOX
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:718-316-5916
Mailing Address - Street 1:3915 BLACKBURN LN APT 41
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-1226
Mailing Address - Country:US
Mailing Address - Phone:718-316-5916
Mailing Address - Fax:
Practice Address - Street 1:3915 BLACKBURN LN APT 41
Practice Address - Street 2:
Practice Address - City:BURTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20866-1226
Practice Address - Country:US
Practice Address - Phone:718-316-5916
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-26
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02292171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty