Provider Demographics
NPI:1891237343
Name:GET WELL ACUPUNCTURE
Entity Type:Organization
Organization Name:GET WELL ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MS
Authorized Official - First Name:GINA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HORTON
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:626-833-4603
Mailing Address - Street 1:508 S MERIDIAN AVE
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-3046
Mailing Address - Country:US
Mailing Address - Phone:626-833-4603
Mailing Address - Fax:
Practice Address - Street 1:890 TOWN CENTER DR
Practice Address - Street 2:B-ANYTIME FITNESS
Practice Address - City:LA CANADA
Practice Address - State:CA
Practice Address - Zip Code:91011-1653
Practice Address - Country:US
Practice Address - Phone:626-415-8616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC17415171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty