Provider Demographics
NPI:1649629825
Name:ITS TREATABLE ACUPUNCTURE HERBS
Entity type:Organization
Organization Name:ITS TREATABLE ACUPUNCTURE HERBS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER ACUPUNCTURE/ HERBS
Authorized Official - Prefix:MS
Authorized Official - First Name:NADIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HARDING
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:818-882-9765
Mailing Address - Street 1:10030 LIMERICK AVE,
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311
Mailing Address - Country:US
Mailing Address - Phone:818-882-9765
Mailing Address - Fax:818-882-9765
Practice Address - Street 1:10030 LIMERICK AVE
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311
Practice Address - Country:US
Practice Address - Phone:818-882-9765
Practice Address - Fax:818-882-9765
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ITS TREATABLE ACUPUNCTURE HERBS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC6992171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty