Provider Demographics
NPI:1437619830
Name:NEIGHBORHOOD ACUPUNCTURE & HEALING ARTS
Entity Type:Organization
Organization Name:NEIGHBORHOOD ACUPUNCTURE & HEALING ARTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:WISELY
Authorized Official - Suffix:II
Authorized Official - Credentials:ERYT
Authorized Official - Phone:801-662-8610
Mailing Address - Street 1:12582 S FORT ST
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-9447
Mailing Address - Country:US
Mailing Address - Phone:801-662-8610
Mailing Address - Fax:
Practice Address - Street 1:12582 S FORT ST
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-9447
Practice Address - Country:US
Practice Address - Phone:801-662-8610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-21
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty