Provider Demographics
NPI:1134441918
Name:STILL MOUNTAIN ACUPUNCTURE INC.
Entity type:Organization
Organization Name:STILL MOUNTAIN ACUPUNCTURE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:OLENICK
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:530-401-8227
Mailing Address - Street 1:202 PROVIDENCE MINE RD
Mailing Address - Street 2:STE.205
Mailing Address - City:NEVADA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95959-2947
Mailing Address - Country:US
Mailing Address - Phone:530-265-1950
Mailing Address - Fax:
Practice Address - Street 1:202 PROVIDENCE MINE RD
Practice Address - Street 2:STE.205
Practice Address - City:NEVADA CITY
Practice Address - State:CA
Practice Address - Zip Code:95959-2947
Practice Address - Country:US
Practice Address - Phone:530-265-1950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-22
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11983171100000X
CAAC12227171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty