Provider Demographics
NPI:1982291597
Name:INNER BALANCE ACUPUNCTURE & HERBS, LLC
Entity type:Organization
Organization Name:INNER BALANCE ACUPUNCTURE & HERBS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:G
Authorized Official - Last Name:ROWE
Authorized Official - Suffix:
Authorized Official - Credentials:LIC AC
Authorized Official - Phone:781-710-5665
Mailing Address - Street 1:210 HUMPHREY ST STE 104
Mailing Address - Street 2:
Mailing Address - City:MARBLEHEAD
Mailing Address - State:MA
Mailing Address - Zip Code:01945-1661
Mailing Address - Country:US
Mailing Address - Phone:781-710-5665
Mailing Address - Fax:978-298-4630
Practice Address - Street 1:210 HUMPHREY ST STE 104
Practice Address - Street 2:
Practice Address - City:MARBLEHEAD
Practice Address - State:MA
Practice Address - Zip Code:01945-1661
Practice Address - Country:US
Practice Address - Phone:781-710-5665
Practice Address - Fax:978-298-4630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty