Provider Demographics
NPI:1881255685
Name:WATKINS ACUPUNCTURE CLINIC, LLC
Entity type:Organization
Organization Name:WATKINS ACUPUNCTURE CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:LIZA
Authorized Official - Middle Name:
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:240-686-5196
Mailing Address - Street 1:23908 JANBEALL CT
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871-9205
Mailing Address - Country:US
Mailing Address - Phone:240-686-5196
Mailing Address - Fax:
Practice Address - Street 1:13217 EXECUTIVE PARK TER
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-2647
Practice Address - Country:US
Practice Address - Phone:240-686-5196
Practice Address - Fax:844-579-0086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-24
Last Update Date:2022-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty