Provider Demographics
NPI:1588891279
Name:NEWPORT ACUPUNCTURE & HERBAL MEDICINE, INC.
Entity type:Organization
Organization Name:NEWPORT ACUPUNCTURE & HERBAL MEDICINE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SETH
Authorized Official - Middle Name:H
Authorized Official - Last Name:BOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DA
Authorized Official - Phone:401-849-0514
Mailing Address - Street 1:850 AQUIDNECK AVE
Mailing Address - Street 2:A3
Mailing Address - City:MIDDLETOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02842-7244
Mailing Address - Country:US
Mailing Address - Phone:401-849-0514
Mailing Address - Fax:401-324-6858
Practice Address - Street 1:850 AQUIDNECK AVE
Practice Address - Street 2:A3
Practice Address - City:MIDDLETOWN
Practice Address - State:RI
Practice Address - Zip Code:02842-7244
Practice Address - Country:US
Practice Address - Phone:401-849-0514
Practice Address - Fax:401-324-6858
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEWPORT ACUPUNCTURE & HERBAL MEDICINE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-19
Last Update Date:2009-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDA 00180171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty