Provider Demographics
NPI:1912599473
Name:SPECTRUM ACUPUNCTURE AND WELLNESS
Entity Type:Organization
Organization Name:SPECTRUM ACUPUNCTURE AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DEVORAH
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:PLOTKIN WALDER
Authorized Official - Suffix:
Authorized Official - Credentials:DAC
Authorized Official - Phone:301-565-2700
Mailing Address - Street 1:8555 16TH ST STE 402
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-2802
Mailing Address - Country:US
Mailing Address - Phone:301-565-2700
Mailing Address - Fax:
Practice Address - Street 1:8555 16TH ST STE 402
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-2802
Practice Address - Country:US
Practice Address - Phone:301-565-2700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-06
Last Update Date:2021-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain