Provider Demographics
NPI:1568071926
Name:EVOLVE ACUPUNCTURE AND WELLNESS
Entity Type:Organization
Organization Name:EVOLVE ACUPUNCTURE AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MARRONE
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:561-901-3899
Mailing Address - Street 1:637 EAST DR
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-8713
Mailing Address - Country:US
Mailing Address - Phone:561-901-3899
Mailing Address - Fax:
Practice Address - Street 1:200 CONGRESS PARK DR STE 230
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445-4688
Practice Address - Country:US
Practice Address - Phone:561-910-3899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty