Provider Demographics
NPI:1467841643
Name:KENSHO VENTURES LLC
Entity Type:Organization
Organization Name:KENSHO VENTURES LLC
Other - Org Name:KENSHO ACUPUNCTURE AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/LICENSED ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHISCHILLY
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:928-600-2868
Mailing Address - Street 1:715 N HUMPHREYS ST
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-3025
Mailing Address - Country:US
Mailing Address - Phone:928-600-2868
Mailing Address - Fax:
Practice Address - Street 1:715 N HUMPHREYS ST
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-3025
Practice Address - Country:US
Practice Address - Phone:928-600-2868
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-12
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0939171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty