Provider Demographics
NPI:1548581135
Name:WEST PALM WELLNESS, INC.
Entity Type:Organization
Organization Name:WEST PALM WELLNESS, INC.
Other - Org Name:WEST PALM ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:BARON
Authorized Official - Suffix:
Authorized Official - Credentials:AP
Authorized Official - Phone:561-247-1407
Mailing Address - Street 1:255 EVERNIA ST
Mailing Address - Street 2:1004
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-5678
Mailing Address - Country:US
Mailing Address - Phone:561-655-6061
Mailing Address - Fax:
Practice Address - Street 1:330 CLEMATIS ST
Practice Address - Street 2:104
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33401-4657
Practice Address - Country:US
Practice Address - Phone:561-247-1407
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2835171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty