Provider Demographics
NPI:1962263947
Name:THERAPEUTIC ACUPUNCTURE LLC
Entity type:Organization
Organization Name:THERAPEUTIC ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURE PHYSICIAN /OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:RISER
Authorized Official - Suffix:
Authorized Official - Credentials:AP
Authorized Official - Phone:321-294-7416
Mailing Address - Street 1:1360 S PATRICK DR STE 10
Mailing Address - Street 2:
Mailing Address - City:SATELLITE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32937-4316
Mailing Address - Country:US
Mailing Address - Phone:321-294-7416
Mailing Address - Fax:914-617-5971
Practice Address - Street 1:1360 S PATRICK DR STE 10
Practice Address - Street 2:
Practice Address - City:SATELLITE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32937-4316
Practice Address - Country:US
Practice Address - Phone:321-294-7416
Practice Address - Fax:914-617-5971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty