Provider Demographics
NPI:1427693233
Name:RADIANT WELLNESS & ACUPUNCTURE CENTER LLC
Entity type:Organization
Organization Name:RADIANT WELLNESS & ACUPUNCTURE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ACUPUNCTURIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:L
Authorized Official - Last Name:WOO
Authorized Official - Suffix:
Authorized Official - Credentials:LIC AC
Authorized Official - Phone:508-343-7373
Mailing Address - Street 1:203 UNION ST
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-6060
Mailing Address - Country:US
Mailing Address - Phone:508-343-7373
Mailing Address - Fax:
Practice Address - Street 1:203 UNION ST
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-6060
Practice Address - Country:US
Practice Address - Phone:508-343-7373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-15
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty