Provider Demographics
NPI:1407491061
Name:WEST HARTFORD ACUPUNCTURE
Entity Type:Organization
Organization Name:WEST HARTFORD ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KLEIBER
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:860-503-3676
Mailing Address - Street 1:173 OAKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06119-2141
Mailing Address - Country:US
Mailing Address - Phone:860-503-3676
Mailing Address - Fax:860-503-3708
Practice Address - Street 1:173 OAKWOOD AVE
Practice Address - Street 2:
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06119-2141
Practice Address - Country:US
Practice Address - Phone:860-503-3676
Practice Address - Fax:860-503-3708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-07
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty