Provider Demographics
NPI:1699040626
Name:ACUPUNCTURE@HAERBALSPECIALISTS
Entity Type:Organization
Organization Name:ACUPUNCTURE@HAERBALSPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURE PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:HALSEY
Authorized Official - Suffix:
Authorized Official - Credentials:DOM,AP
Authorized Official - Phone:727-505-4574
Mailing Address - Street 1:8604 LITTLE ROAD
Mailing Address - Street 2:
Mailing Address - City:NEWPORTRICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34654
Mailing Address - Country:US
Mailing Address - Phone:727-505-4574
Mailing Address - Fax:727-846-8900
Practice Address - Street 1:8604 LITTLE RD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34654-4945
Practice Address - Country:US
Practice Address - Phone:727-505-4574
Practice Address - Fax:727-846-8900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-08
Last Update Date:2012-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 2212261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service