Provider Demographics
NPI:1912401241
Name:AVERY ACUPUNCTURE & NATURAL MEDICINE INC.
Entity Type:Organization
Organization Name:AVERY ACUPUNCTURE & NATURAL MEDICINE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:EVELYN
Authorized Official - Last Name:AVERY
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:805-400-9723
Mailing Address - Street 1:1704 SPRING ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93446
Mailing Address - Country:US
Mailing Address - Phone:805-400-9723
Mailing Address - Fax:
Practice Address - Street 1:1704 SPRING ST
Practice Address - Street 2:SUITE 202
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446
Practice Address - Country:US
Practice Address - Phone:805-400-9723
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-21
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13614171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty