Provider Demographics
NPI:1770208464
Name:HOLISTIC HEALING ACUPUNCTURE PC
Entity type:Organization
Organization Name:HOLISTIC HEALING ACUPUNCTURE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:BAILA
Authorized Official - Last Name:HAYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC MSAOM
Authorized Official - Phone:208-310-8887
Mailing Address - Street 1:2008 W SUNRISE RIM RD
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705-5142
Mailing Address - Country:US
Mailing Address - Phone:208-310-8887
Mailing Address - Fax:
Practice Address - Street 1:5318 W MORRIS HILL RD
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-1619
Practice Address - Country:US
Practice Address - Phone:208-310-8887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-05
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDACU-433OtherHEALTH INSURANCE