Provider Demographics
NPI:1952064800
Name:5 ELEMENT ACUPUNCTURE CENTER
Entity Type:Organization
Organization Name:5 ELEMENT ACUPUNCTURE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTITIONER OF ACUPUNCTURE
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:MITTS
Authorized Official - Suffix:
Authorized Official - Credentials:L AC
Authorized Official - Phone:928-514-9965
Mailing Address - Street 1:7931 E. BELLEVISTA LANE
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86315
Mailing Address - Country:US
Mailing Address - Phone:425-306-2926
Mailing Address - Fax:
Practice Address - Street 1:3681 N. ROBERT ROAD
Practice Address - Street 2:SUITE A
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314
Practice Address - Country:US
Practice Address - Phone:928-514-9965
Practice Address - Fax:928-237-2215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-18
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy