Provider Demographics
NPI:1386071231
Name:ACUPUNCTURE AND PAIN CLINIC CENTER PLLC
Entity type:Organization
Organization Name:ACUPUNCTURE AND PAIN CLINIC CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOSTAFA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELKHALFIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-312-7786
Mailing Address - Street 1:2608 WOODCREEK CT
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48188-2642
Mailing Address - Country:US
Mailing Address - Phone:313-312-7786
Mailing Address - Fax:313-584-0552
Practice Address - Street 1:5141 OAKMAN BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-3763
Practice Address - Country:US
Practice Address - Phone:313-312-7786
Practice Address - Fax:313-584-0552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-07
Last Update Date:2013-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5401000061171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty