Provider Demographics
NPI:1346628013
Name:NICOLE ASBAHR, M.AC, L.AC, LICENSED ACUPUNCTURIST
Entity Type:Organization
Organization Name:NICOLE ASBAHR, M.AC, L.AC, LICENSED ACUPUNCTURIST
Other - Org Name:INNER NATURE ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:ASBAHR
Authorized Official - Suffix:
Authorized Official - Credentials:MAC, LAC
Authorized Official - Phone:503-351-4033
Mailing Address - Street 1:112 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-1233
Mailing Address - Country:US
Mailing Address - Phone:503-351-4033
Mailing Address - Fax:
Practice Address - Street 1:112 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-1233
Practice Address - Country:US
Practice Address - Phone:503-351-4033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-13
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02242171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty