Provider Demographics
NPI:1760573554
Name:ACTON ACUPUNCTURE & ALTERNATIVE HEALING CENTER, A PROFESSIONAL CORP
Entity Type:Organization
Organization Name:ACTON ACUPUNCTURE & ALTERNATIVE HEALING CENTER, A PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-269-2020
Mailing Address - Street 1:33315 SANTIAGO RD
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:CA
Mailing Address - Zip Code:93510-1416
Mailing Address - Country:US
Mailing Address - Phone:661-269-2020
Mailing Address - Fax:661-269-2120
Practice Address - Street 1:33315 SANTIAGO RD
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:CA
Practice Address - Zip Code:93510-1416
Practice Address - Country:US
Practice Address - Phone:661-269-2020
Practice Address - Fax:661-269-2120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 8473171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty