Provider Demographics
NPI:1376104208
Name:ACUWELL LLC
Entity Type:Organization
Organization Name:ACUWELL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHORE
Authorized Official - Suffix:
Authorized Official - Credentials:ND, MSOM, LAC
Authorized Official - Phone:630-283-8817
Mailing Address - Street 1:300 E OGDEN AVE
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-3159
Mailing Address - Country:US
Mailing Address - Phone:630-283-8817
Mailing Address - Fax:630-358-6433
Practice Address - Street 1:300 E OGDEN AVE
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-3159
Practice Address - Country:US
Practice Address - Phone:630-283-8817
Practice Address - Fax:630-358-6433
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-21
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty