Provider Demographics
NPI:1528390119
Name:THE CENTER FOR THE MARTIAL ARTS AND HOLISTIC STUDIES, INC.
Entity Type:Organization
Organization Name:THE CENTER FOR THE MARTIAL ARTS AND HOLISTIC STUDIES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:L.AC.
Authorized Official - Prefix:MR
Authorized Official - First Name:DETLEF
Authorized Official - Middle Name:F
Authorized Official - Last Name:WOLF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-485-1770
Mailing Address - Street 1:315 TITUSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-2917
Mailing Address - Country:US
Mailing Address - Phone:845-485-1770
Mailing Address - Fax:
Practice Address - Street 1:315 TITUSVILLE RD
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-2917
Practice Address - Country:US
Practice Address - Phone:845-485-1770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-05
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY000734171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty