Provider Demographics
NPI:1023323920
Name:NOLA ACUPUNCTURE WELLNESS CENTER
Entity type:Organization
Organization Name:NOLA ACUPUNCTURE WELLNESS CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MR
Authorized Official - First Name:QUANG
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:504-377-2929
Mailing Address - Street 1:3712 MACARTHUR BLVD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70114-6802
Mailing Address - Country:US
Mailing Address - Phone:504-362-8020
Mailing Address - Fax:
Practice Address - Street 1:3712 MACARTHUR BLVD
Practice Address - Street 2:SUITE 208
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70114-6802
Practice Address - Country:US
Practice Address - Phone:504-362-8020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-16
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA200029171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty