Provider Demographics
NPI:1821209933
Name:LAWRENCEVILLE ACUPUNCTURE CENTER, LLC
Entity Type:Organization
Organization Name:LAWRENCEVILLE ACUPUNCTURE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:URICH
Authorized Official - Suffix:
Authorized Official - Credentials:CA
Authorized Official - Phone:609-883-0080
Mailing Address - Street 1:1651 LAWRENCEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2901
Mailing Address - Country:US
Mailing Address - Phone:609-883-0080
Mailing Address - Fax:609-538-1969
Practice Address - Street 1:1651 LAWRENCEVILLE RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2901
Practice Address - Country:US
Practice Address - Phone:609-883-0080
Practice Address - Fax:609-538-1969
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00001300171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty