Provider Demographics
NPI:1659673911
Name:GENTLE HEALING LLC
Entity Type:Organization
Organization Name:GENTLE HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:POWERS
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:321-752-0402
Mailing Address - Street 1:2351 W EAU GALLIE BLVD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-3114
Mailing Address - Country:US
Mailing Address - Phone:321-753-0402
Mailing Address - Fax:
Practice Address - Street 1:2351 W EAU GALLIE BLVD
Practice Address - Street 2:SUITE 7
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-3114
Practice Address - Country:US
Practice Address - Phone:321-753-0402
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-18
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2786261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service