Provider Demographics
NPI:1942453238
Name:ACUPUNCTURE-WELLBEING, LLC
Entity Type:Organization
Organization Name:ACUPUNCTURE-WELLBEING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:YOUNGBOK
Authorized Official - Last Name:JO
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:574-210-0185
Mailing Address - Street 1:11696 SHARPE BRIDGE CT.
Mailing Address - Street 2:
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-8108
Mailing Address - Country:US
Mailing Address - Phone:574-273-2479
Mailing Address - Fax:574-273-2479
Practice Address - Street 1:17060 STATE ROAD 23
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46635-1518
Practice Address - Country:US
Practice Address - Phone:574-210-0185
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-30
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN84000059A171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty