Provider Demographics
NPI:1477212181
Name:JAPANESE ACUPUNCTURE CLINIC LLC
Entity Type:Organization
Organization Name:JAPANESE ACUPUNCTURE CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMIE
Authorized Official - Middle Name:T
Authorized Official - Last Name:BILAZZO
Authorized Official - Suffix:
Authorized Official - Credentials:LIC AC
Authorized Official - Phone:781-254-2206
Mailing Address - Street 1:394 LOWELL ST STE 10
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02420-2549
Mailing Address - Country:US
Mailing Address - Phone:781-254-2206
Mailing Address - Fax:
Practice Address - Street 1:394 LOWELL ST STE 10
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-2549
Practice Address - Country:US
Practice Address - Phone:781-254-2206
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-09
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty