Ross Lake ROSS LAKE

NPI 1639247034 - Acupuncturist - 171100000X

NPI Details
NPI 1639247034
Gender Male
Enumeration Date 12/01/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
236 S HUMBOLDT ST
WILLITS CA, 95490-3514, US
Phone (707) 459-2488
Fax (707) 459-2228
Business Location
236 S HUMBOLDT ST
WILLITS CA, 95490-3514, US
Phone (707) 459-2488
Fax (707) 459-2228
Toxanomy
Taxonomy Code 171100000X
License State California
License Number AC2909
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According to our database, Ross Lake ROSS LAKE NPI is 1639247034, taxonomy code is 171100000X and license number is AC2909, license state is located at California. Ross Lake ROSS LAKE physically located at 236 S Humboldt St, Willits CA, 95490-3514. NPI Number Ross Lake ROSS LAKE has the Individual type.

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1639247034 NPI number is provided on an as is basis without warranty of any kind. 1639247034 is maintained by the National Plan & Provider Enumeration System. The contents of Ross Lake ROSS LAKE are for informational purposes only.