Provider Demographics
NPI:1851871255
Name:BRIGHT SIDE ACUPUNCTURE, INC
Entity Type:Organization
Organization Name:BRIGHT SIDE ACUPUNCTURE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EKATERINA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-465-3555
Mailing Address - Street 1:617 MARINER WAY
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-5420
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:210 N WESTMONTE DR STE 2004
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-3357
Practice Address - Country:US
Practice Address - Phone:407-675-7757
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty