Provider Demographics
NPI:1629822408
Name:ACCU-ALLY LLC
Entity Type:Organization
Organization Name:ACCU-ALLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALLYSON
Authorized Official - Middle Name:
Authorized Official - Last Name:LANGE-SOST
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:850-591-6190
Mailing Address - Street 1:4915 LAVISTA RD STE B
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-8520
Mailing Address - Country:US
Mailing Address - Phone:850-591-6190
Mailing Address - Fax:
Practice Address - Street 1:4915 LAVISTA RD STE B
Practice Address - Street 2:
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-8520
Practice Address - Country:US
Practice Address - Phone:850-591-6190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty