Provider Demographics
NPI:1497341382
Name:BACK TO CENTER ACUPUNCTURE, LLC
Entity Type:Organization
Organization Name:BACK TO CENTER ACUPUNCTURE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:
Authorized Official - Last Name:LEINER
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:443-844-7650
Mailing Address - Street 1:PO BOX 973
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21158-0973
Mailing Address - Country:US
Mailing Address - Phone:410-848-5785
Mailing Address - Fax:410-848-5629
Practice Address - Street 1:29 BROAD ST STE 205
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:MD
Practice Address - Zip Code:21811-1055
Practice Address - Country:US
Practice Address - Phone:443-844-7650
Practice Address - Fax:410-848-5629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty