Provider Demographics
NPI:1407389687
Name:ACUPUNCTURE MEDICAL SOLUTIONS, INC.
Entity Type:Organization
Organization Name:ACUPUNCTURE MEDICAL SOLUTIONS, INC.
Other - Org Name:ACUPUNCTURE PAIN SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/ CEO
Authorized Official - Prefix:
Authorized Official - First Name:WILL
Authorized Official - Middle Name:
Authorized Official - Last Name:ZUHIRA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:815-410-4004
Mailing Address - Street 1:944 4TH STREET
Mailing Address - Street 2:
Mailing Address - City:PERU
Mailing Address - State:IL
Mailing Address - Zip Code:61354-4581
Mailing Address - Country:US
Mailing Address - Phone:815-410-4006
Mailing Address - Fax:309-807-3348
Practice Address - Street 1:409 S PROSPECT RD
Practice Address - Street 2:SUITE E
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61704-4581
Practice Address - Country:US
Practice Address - Phone:309-807-3343
Practice Address - Fax:309-807-3348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-05
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.010923111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty