Provider Demographics
NPI:1154695773
Name:MURFREESBORO ACUPUNCTURE AND MASSAGE
Entity type:Organization
Organization Name:MURFREESBORO ACUPUNCTURE AND MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ACUPUNCTURIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:HOLT
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:615-890-6996
Mailing Address - Street 1:304 UPTOWN SQ
Mailing Address - Street 2:SUITE A
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-0583
Mailing Address - Country:US
Mailing Address - Phone:615-890-6996
Mailing Address - Fax:
Practice Address - Street 1:304 UPTOWN SQ
Practice Address - Street 2:SUITE A
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-0583
Practice Address - Country:US
Practice Address - Phone:615-890-6996
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-29
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN000849171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty