Provider Demographics
NPI:1639847734
Name:CLARITY ACUPUNCTURE
Entity Type:Organization
Organization Name:CLARITY ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SUPSIC
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:267-690-0795
Mailing Address - Street 1:624 BRIDLE RD
Mailing Address - Street 2:
Mailing Address - City:GLENSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:19038-2004
Mailing Address - Country:US
Mailing Address - Phone:267-690-0795
Mailing Address - Fax:
Practice Address - Street 1:827 GLENSIDE AVE STE C
Practice Address - Street 2:
Practice Address - City:WYNCOTE
Practice Address - State:PA
Practice Address - Zip Code:19095-1221
Practice Address - Country:US
Practice Address - Phone:267-690-0795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-02
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center