Provider Demographics
NPI:1275999120
Name:FIVE SHEN WELLNESS, INC
Entity Type:Organization
Organization Name:FIVE SHEN WELLNESS, INC
Other - Org Name:JING SHEN HEALING ARTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:DACM
Authorized Official - Phone:406-309-3483
Mailing Address - Street 1:PO BOX 471
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59903-0471
Mailing Address - Country:US
Mailing Address - Phone:406-309-3483
Mailing Address - Fax:
Practice Address - Street 1:149 MAIN ST
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-4451
Practice Address - Country:US
Practice Address - Phone:406-309-3483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-07
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCACUP248171100000X
171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty