Provider Demographics
NPI:1518726595
Name:ROSE POINT ACUPUNCTURE LLC
Entity Type:Organization
Organization Name:ROSE POINT ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST, OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEDERSEN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:630-280-6044
Mailing Address - Street 1:350 W 22ND ST STE 112
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-6447
Mailing Address - Country:US
Mailing Address - Phone:630-280-6044
Mailing Address - Fax:
Practice Address - Street 1:350 W 22ND ST STE 112
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-6447
Practice Address - Country:US
Practice Address - Phone:630-280-6044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty