Provider Demographics
NPI:1750106456
Name:CAROLINA FAMILY ACUPUNCTURE LLC
Entity type:Organization
Organization Name:CAROLINA FAMILY ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:SULLIVAN
Authorized Official - Last Name:GARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, DAOM
Authorized Official - Phone:831-466-6850
Mailing Address - Street 1:1218 JOHN B WHITE SR BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29306-3920
Mailing Address - Country:US
Mailing Address - Phone:530-809-6712
Mailing Address - Fax:
Practice Address - Street 1:1218 JOHN B WHITE SR BLVD STE E
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29306-3920
Practice Address - Country:US
Practice Address - Phone:864-309-0200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service