Provider Demographics
NPI:1740543313
Name:COASTAL ACUPUNCTURE, LLC
Entity type:Organization
Organization Name:COASTAL ACUPUNCTURE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NETTA
Authorized Official - Middle Name:M
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:LIC ACU
Authorized Official - Phone:603-433-1727
Mailing Address - Street 1:18 COASTAL WAY
Mailing Address - Street 2:
Mailing Address - City:GREENLAND
Mailing Address - State:NH
Mailing Address - Zip Code:03840-2601
Mailing Address - Country:US
Mailing Address - Phone:603-433-1727
Mailing Address - Fax:603-373-0356
Practice Address - Street 1:18 COASTAL WAY
Practice Address - Street 2:
Practice Address - City:GREENLAND
Practice Address - State:NH
Practice Address - Zip Code:03840-2601
Practice Address - Country:US
Practice Address - Phone:603-433-1727
Practice Address - Fax:603-373-0356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH015171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty