Provider Demographics
NPI:1780043315
Name:CENTERED RICHMOND ACUPUNCTURE AND WELLNESS
Entity Type:Organization
Organization Name:CENTERED RICHMOND ACUPUNCTURE AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HODGE
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:804-234-3843
Mailing Address - Street 1:20 N 20TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-6976
Mailing Address - Country:US
Mailing Address - Phone:804-234-3843
Mailing Address - Fax:804-482-2506
Practice Address - Street 1:20 N 20TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-6976
Practice Address - Country:US
Practice Address - Phone:804-234-3843
Practice Address - Fax:804-482-2506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-10
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000639171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty