Provider Demographics
NPI:1881862340
Name:EAST WIND ACUPUNCTURE, LLC
Entity Type:Organization
Organization Name:EAST WIND ACUPUNCTURE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:BUYZE
Authorized Official - Suffix:
Authorized Official - Credentials:CAC
Authorized Official - Phone:920-997-0511
Mailing Address - Street 1:2600 N RICHMOND ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-1956
Mailing Address - Country:US
Mailing Address - Phone:920-997-0511
Mailing Address - Fax:920-968-8806
Practice Address - Street 1:2600 N RICHMOND ST
Practice Address - Street 2:SUITE C
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-1956
Practice Address - Country:US
Practice Address - Phone:920-997-0511
Practice Address - Fax:920-968-8806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-18
Last Update Date:2008-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center