Provider Demographics
NPI:1598010498
Name:LEHIGH VALLEY ORIENTAL MEDICINE CENTRE, LLC
Entity Type:Organization
Organization Name:LEHIGH VALLEY ORIENTAL MEDICINE CENTRE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTITIONER OF ORIENTAL MEDICINE
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:EDGAR
Authorized Official - Last Name:MOLONY
Authorized Official - Suffix:
Authorized Official - Credentials:DOM
Authorized Official - Phone:610-264-2755
Mailing Address - Street 1:101 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:CATASAUQUA
Mailing Address - State:PA
Mailing Address - Zip Code:18032-2506
Mailing Address - Country:US
Mailing Address - Phone:610-264-2755
Mailing Address - Fax:610-264-7292
Practice Address - Street 1:101 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:CATASAUQUA
Practice Address - State:PA
Practice Address - Zip Code:18032-2506
Practice Address - Country:US
Practice Address - Phone:610-264-2755
Practice Address - Fax:610-264-7292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-17
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOM00040171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty