Provider Demographics
NPI:1982016002
Name:ACUPUNCTURE AND HERBAL SOLUTIONS, INC
Entity Type:Organization
Organization Name:ACUPUNCTURE AND HERBAL SOLUTIONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURE PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DOMINIQUE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:VONADOR
Authorized Official - Suffix:
Authorized Official - Credentials:DOM, LAC, AP
Authorized Official - Phone:321-266-6475
Mailing Address - Street 1:2215 59TH ST W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34209-7017
Mailing Address - Country:US
Mailing Address - Phone:321-266-6475
Mailing Address - Fax:
Practice Address - Street 1:2215 59TH ST W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34209-7017
Practice Address - Country:US
Practice Address - Phone:321-266-6475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-22
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3455261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service