Provider Demographics
NPI:1629627419
Name:HEALING LIGHT ACUPUNCTURE, INC.
Entity Type:Organization
Organization Name:HEALING LIGHT ACUPUNCTURE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:KRAUSE
Authorized Official - Suffix:
Authorized Official - Credentials:MAOM
Authorized Official - Phone:802-662-5882
Mailing Address - Street 1:4 KELLOGG RD STE 6
Mailing Address - Street 2:
Mailing Address - City:ESSEX JUNCTION
Mailing Address - State:VT
Mailing Address - Zip Code:05452-2815
Mailing Address - Country:US
Mailing Address - Phone:802-662-5882
Mailing Address - Fax:
Practice Address - Street 1:4 KELLOGG RD STE 6
Practice Address - Street 2:
Practice Address - City:ESSEX JUNCTION
Practice Address - State:VT
Practice Address - Zip Code:05452-2815
Practice Address - Country:US
Practice Address - Phone:802-662-5882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-05
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty