Provider Demographics
NPI:1821557497
Name:JOSEPHINE WOLF ACUPUNCTURE INCORPORATED
Entity Type:Organization
Organization Name:JOSEPHINE WOLF ACUPUNCTURE INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-430-1291
Mailing Address - Street 1:33 EASTWIND ST APT 3
Mailing Address - Street 2:
Mailing Address - City:MARINA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90292-5786
Mailing Address - Country:US
Mailing Address - Phone:310-430-1291
Mailing Address - Fax:
Practice Address - Street 1:33 EASTWIND ST APT 3
Practice Address - Street 2:
Practice Address - City:MARINA DEL REY
Practice Address - State:CA
Practice Address - Zip Code:90292-5786
Practice Address - Country:US
Practice Address - Phone:310-430-1291
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-13
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty