Provider Demographics
NPI:1295186021
Name:ACUTRIBE LLC
Entity Type:Organization
Organization Name:ACUTRIBE LLC
Other - Org Name:ACUTRIBE HEALTH & WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:MAGGARD
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:907-458-7423
Mailing Address - Street 1:PO BOX 72523
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99707-2523
Mailing Address - Country:US
Mailing Address - Phone:907-458-7423
Mailing Address - Fax:907-458-7424
Practice Address - Street 1:1222 WELL ST
Practice Address - Street 2:SUITE 1
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-2835
Practice Address - Country:US
Practice Address - Phone:907-458-7423
Practice Address - Fax:907-458-7424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-22
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKACUA121171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty