Provider Demographics
NPI:1710353511
Name:WARK, SVETLANA (L AC, DIPL OM)
Entity Type:Individual
Prefix:
First Name:SVETLANA
Middle Name:
Last Name:WARK
Suffix:
Gender:F
Credentials:L AC, DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 119
Mailing Address - Street 2:
Mailing Address - City:SKYLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28776-0119
Mailing Address - Country:US
Mailing Address - Phone:828-423-8896
Mailing Address - Fax:
Practice Address - Street 1:43 GROVE ST STE 1
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-3265
Practice Address - Country:US
Practice Address - Phone:828-423-8896
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-15
Last Update Date:2015-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC739171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist