Provider Demographics
NPI:1275081648
Name:SIX FISHES NEIGHBORHOOD ACUPUNCTURE LLC
Entity Type:Organization
Organization Name:SIX FISHES NEIGHBORHOOD ACUPUNCTURE LLC
Other - Org Name:CARA FRANK, R.AC. INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CARA
Authorized Official - Middle Name:OSKA
Authorized Official - Last Name:FRANK
Authorized Official - Suffix:
Authorized Official - Credentials:LOM
Authorized Official - Phone:215-772-0770
Mailing Address - Street 1:2308 GRAYS FERRY AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19146-1177
Mailing Address - Country:US
Mailing Address - Phone:215-772-1040
Mailing Address - Fax:866-620-5360
Practice Address - Street 1:750 S 15TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19146-2186
Practice Address - Country:US
Practice Address - Phone:215-772-0770
Practice Address - Fax:866-620-5360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA000018OM171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty