Provider Demographics
NPI:1922125749
Name:ARURA CORPORATION
Entity Type:Organization
Organization Name:ARURA CORPORATION
Other - Org Name:BITTERROOT ACUPUNCTURE & HERBARIUM
Other - Org Type:Other Name
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:WATROUS
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, DIPLOM
Authorized Official - Phone:406-531-0627
Mailing Address - Street 1:1211 S RESERVE ST
Mailing Address - Street 2:SUITE 202A
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-3101
Mailing Address - Country:US
Mailing Address - Phone:406-531-0627
Mailing Address - Fax:406-549-0987
Practice Address - Street 1:1211 S RESERVE ST
Practice Address - Street 2:SUITE 202A
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-3101
Practice Address - Country:US
Practice Address - Phone:406-531-0627
Practice Address - Fax:406-549-0987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-25
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT200171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty