Provider Demographics
NPI:1336808302
Name:MERIDIAN ACUPUNCTURE LLC
Entity Type:Organization
Organization Name:MERIDIAN ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVEMARK
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:541-517-9869
Mailing Address - Street 1:PO BOX 127
Mailing Address - Street 2:
Mailing Address - City:DAYS CREEK
Mailing Address - State:OR
Mailing Address - Zip Code:97429-0127
Mailing Address - Country:US
Mailing Address - Phone:541-860-1515
Mailing Address - Fax:541-543-2220
Practice Address - Street 1:213 S OLD PACIFIC HWY STE 100
Practice Address - Street 2:
Practice Address - City:MYRTLE CREEK
Practice Address - State:OR
Practice Address - Zip Code:97457-8785
Practice Address - Country:US
Practice Address - Phone:541-860-1515
Practice Address - Fax:541-543-2220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-16
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty