Provider Demographics
NPI:1942860168
Name:CHANGING ELEMENTS ACUPUNCTURE PLLC
Entity Type:Organization
Organization Name:CHANGING ELEMENTS ACUPUNCTURE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:ATALIE
Authorized Official - Middle Name:CHRISTING
Authorized Official - Last Name:MAYER
Authorized Official - Suffix:
Authorized Official - Credentials:AP
Authorized Official - Phone:321-345-8228
Mailing Address - Street 1:1989 TYLER AVE
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-4061
Mailing Address - Country:US
Mailing Address - Phone:414-426-9911
Mailing Address - Fax:321-574-6788
Practice Address - Street 1:134 5TH AVE STE 102
Practice Address - Street 2:
Practice Address - City:INDIALANTIC
Practice Address - State:FL
Practice Address - Zip Code:32903-3133
Practice Address - Country:US
Practice Address - Phone:321-345-8228
Practice Address - Fax:321-574-6788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-19
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty