Provider Demographics
NPI:1437664869
Name:ACUPUNCTURE OF CLEVELAND, LLC
Entity Type:Organization
Organization Name:ACUPUNCTURE OF CLEVELAND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:ELISE
Authorized Official - Middle Name:C
Authorized Official - Last Name:BREWKA
Authorized Official - Suffix:
Authorized Official - Credentials:L AC
Authorized Official - Phone:216-570-9818
Mailing Address - Street 1:3553 TUTTLE AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-3030
Mailing Address - Country:US
Mailing Address - Phone:216-570-9818
Mailing Address - Fax:
Practice Address - Street 1:23215 COMMERCE PARK STE 102
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5843
Practice Address - Country:US
Practice Address - Phone:216-570-9818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-07
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH65.000337171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty