Provider Demographics
NPI:1740790526
Name:ACUPUNCTURE HEALTHCARE CLINIC, INC.
Entity Type:Organization
Organization Name:ACUPUNCTURE HEALTHCARE CLINIC, INC.
Other - Org Name:BURTON MOOMAW ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:A.
Authorized Official - Middle Name:BURTON
Authorized Official - Last Name:MOOMAW
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:828-264-2322
Mailing Address - Street 1:184 S DEPOT ST
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-4016
Mailing Address - Country:US
Mailing Address - Phone:828-264-2322
Mailing Address - Fax:828-264-2322
Practice Address - Street 1:184 S DEPOT ST
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-4016
Practice Address - Country:US
Practice Address - Phone:828-264-2322
Practice Address - Fax:828-264-2322
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-05
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC458261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty