Provider Demographics
NPI:1932433430
Name:EAST WIND ACUPUNCTURE, INCORPORATED
Entity Type:Organization
Organization Name:EAST WIND ACUPUNCTURE, INCORPORATED
Other - Org Name:EAST WIND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:ZARANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:L AC, PH D
Authorized Official - Phone:219-395-9928
Mailing Address - Street 1:60 E OAK HILL RD
Mailing Address - Street 2:
Mailing Address - City:PORTER
Mailing Address - State:IN
Mailing Address - Zip Code:46304-1363
Mailing Address - Country:US
Mailing Address - Phone:219-395-9928
Mailing Address - Fax:219-395-1960
Practice Address - Street 1:210 N CALUMET RD
Practice Address - Street 2:
Practice Address - City:CHESTERTON
Practice Address - State:IN
Practice Address - Zip Code:46304-2428
Practice Address - Country:US
Practice Address - Phone:219-395-9928
Practice Address - Fax:219-395-1960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-30
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN84000044A171100000X
IN84000086A171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty