Provider Demographics
NPI:1508163866
Name:ACUPUNCTURE AND PAIN MANAGEMENT INC
Entity Type:Organization
Organization Name:ACUPUNCTURE AND PAIN MANAGEMENT INC
Other - Org Name:MCDERMOTT WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDERMOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DOM
Authorized Official - Phone:239-254-0001
Mailing Address - Street 1:860 111TH AVE N
Mailing Address - Street 2:SUITE 3
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34108-1829
Mailing Address - Country:US
Mailing Address - Phone:239-254-0001
Mailing Address - Fax:
Practice Address - Street 1:860 111TH AVE N
Practice Address - Street 2:SUITE 3
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34108-1829
Practice Address - Country:US
Practice Address - Phone:239-254-0001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-23
Last Update Date:2017-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2853171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty