Provider Demographics
NPI:1518381565
Name:DORRANCE SEXTON D.O.M., L.AC.
Entity Type:Organization
Organization Name:DORRANCE SEXTON D.O.M., L.AC.
Other - Org Name:PALM BEACH COUNTY ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR OF ORIENTAL MEDICINE, LICENS
Authorized Official - Prefix:MR
Authorized Official - First Name:DORRANCE
Authorized Official - Middle Name:
Authorized Official - Last Name:SEXTON
Authorized Official - Suffix:
Authorized Official - Credentials:DOM,LAC
Authorized Official - Phone:561-325-8612
Mailing Address - Street 1:455 NE 5TH AVE
Mailing Address - Street 2:SUITE D-175
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5658
Mailing Address - Country:US
Mailing Address - Phone:561-891-9159
Mailing Address - Fax:
Practice Address - Street 1:160 SE 6TH AVE
Practice Address - Street 2:SUITE B-2
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-5264
Practice Address - Country:US
Practice Address - Phone:561-325-8612
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-11
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3413171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty