Provider Demographics
NPI:1326429549
Name:RED LILY ACUPUNCTURE LLC
Entity Type:Organization
Organization Name:RED LILY ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MURTHA
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:724-366-0401
Mailing Address - Street 1:203 PITTSBURGH ST
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-2772
Mailing Address - Country:US
Mailing Address - Phone:724-366-0401
Mailing Address - Fax:724-439-1113
Practice Address - Street 1:105 BIERER LN
Practice Address - Street 2:UPPER LEVEL
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-3117
Practice Address - Country:US
Practice Address - Phone:724-439-1808
Practice Address - Fax:724-439-1113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-12
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK000974171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty