Provider Demographics
NPI:1194433284
Name:MUSE OF HEALING ACUPUNCTURE & WELLNESS CENTER
Entity type:Organization
Organization Name:MUSE OF HEALING ACUPUNCTURE & WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:TERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FAUGHTNER
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:510-479-5330
Mailing Address - Street 1:PO BOX 22002
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94623-2002
Mailing Address - Country:US
Mailing Address - Phone:510-479-5330
Mailing Address - Fax:
Practice Address - Street 1:3275 PERALTA ST UNIT 332
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94608-4169
Practice Address - Country:US
Practice Address - Phone:510-479-5330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty