Provider Demographics
NPI:1932965035
Name:THE INNER GARDENER
Entity Type:Organization
Organization Name:THE INNER GARDENER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LAC DACM
Authorized Official - Phone:719-200-4591
Mailing Address - Street 1:232 HIGHWAY 441 N STE B
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:GA
Mailing Address - Zip Code:30525-4262
Mailing Address - Country:US
Mailing Address - Phone:828-331-1288
Mailing Address - Fax:
Practice Address - Street 1:232 HIGHWAY 441 N STE B
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:GA
Practice Address - Zip Code:30525-4262
Practice Address - Country:US
Practice Address - Phone:828-331-1288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-26
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty