Provider Demographics
NPI:1588332837
Name:AYM - ACUPUNCTURE YOGA MEDICINE, INC.
Entity type:Organization
Organization Name:AYM - ACUPUNCTURE YOGA MEDICINE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:GILL
Authorized Official - Suffix:II
Authorized Official - Credentials:LAC, DIPL OM
Authorized Official - Phone:678-316-9635
Mailing Address - Street 1:9922 FIELDCREST DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75238-1836
Mailing Address - Country:US
Mailing Address - Phone:678-316-9635
Mailing Address - Fax:
Practice Address - Street 1:10670 N CENTRAL EXPY STE 110
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-2105
Practice Address - Country:US
Practice Address - Phone:678-316-9635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty