Provider Demographics
NPI:1275659724
Name:CHARLOTTE ACUPUNCTURE AND WELLNESS CENTER, INC.
Entity Type:Organization
Organization Name:CHARLOTTE ACUPUNCTURE AND WELLNESS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:704-333-8899
Mailing Address - Street 1:301 S MCDOWELL STREET
Mailing Address - Street 2:SUITE 907
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28204-2623
Mailing Address - Country:US
Mailing Address - Phone:704-333-8899
Mailing Address - Fax:704-333-8090
Practice Address - Street 1:301 S MCDOWELL STREET
Practice Address - Street 2:SUITE 907
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2623
Practice Address - Country:US
Practice Address - Phone:704-333-8899
Practice Address - Fax:704-333-8090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC372171100000X
NC371171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty