Provider Demographics
NPI:1407356470
Name:WEI ACUPUNCTURE OF NEWARK, LTD
Entity Type:Organization
Organization Name:WEI ACUPUNCTURE OF NEWARK, LTD
Other - Org Name:WEI ACUPUNCTURE OF NEWARK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HICKS
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, DIPL AC (NCCA
Authorized Official - Phone:740-334-0485
Mailing Address - Street 1:138 HILLVIEW CT
Mailing Address - Street 2:
Mailing Address - City:HEATH
Mailing Address - State:OH
Mailing Address - Zip Code:43056-5517
Mailing Address - Country:US
Mailing Address - Phone:740-334-0485
Mailing Address - Fax:740-522-0228
Practice Address - Street 1:225 S 21ST ST STE C
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-3875
Practice Address - Country:US
Practice Address - Phone:740-334-0485
Practice Address - Fax:740-522-0228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-16
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH65.000155171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty