Provider Demographics
NPI:1992410112
Name:ACUPUNCTURE BY MOLLY, LLC
Entity type:Organization
Organization Name:ACUPUNCTURE BY MOLLY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCNEEL
Authorized Official - Suffix:
Authorized Official - Credentials:AP
Authorized Official - Phone:315-783-4148
Mailing Address - Street 1:2410 CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-4508
Mailing Address - Country:US
Mailing Address - Phone:315-783-4148
Mailing Address - Fax:352-758-3669
Practice Address - Street 1:301 N TUBB ST STE 114
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:FL
Practice Address - Zip Code:34760-8931
Practice Address - Country:US
Practice Address - Phone:352-325-5938
Practice Address - Fax:352-758-3669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center