Provider Demographics
NPI:1588211577
Name:HOLISTIC MEDICAL SERVICES LLC
Entity Type:Organization
Organization Name:HOLISTIC MEDICAL SERVICES LLC
Other - Org Name:HEALTH SOURCE ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOMINIC
Authorized Official - Middle Name:
Authorized Official - Last Name:SEMBELLO
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:609-248-6922
Mailing Address - Street 1:929 SANDY CIR
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-2551
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:401 NEW RD STE 210
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1200
Practice Address - Country:US
Practice Address - Phone:609-601-2159
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-23
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty