Provider Demographics
NPI:1558811414
Name:GREENVILLE NATURAL HEALTH, INC.
Entity Type:Organization
Organization Name:GREENVILLE NATURAL HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PONTON
Authorized Official - Suffix:
Authorized Official - Credentials:DAOM
Authorized Official - Phone:864-370-1140
Mailing Address - Street 1:16 MILLS AVE
Mailing Address - Street 2:STE. 8
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-4070
Mailing Address - Country:US
Mailing Address - Phone:864-370-1140
Mailing Address - Fax:
Practice Address - Street 1:16 MILLS AVE
Practice Address - Street 2:STE. 8
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4070
Practice Address - Country:US
Practice Address - Phone:864-370-1140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-04
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1609833136OtherPRESIDENT'S NPI NUMBER