| NPI | 1093167991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN CLARK Owner 302-249-0143 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: NJ 25MZ00104200) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: NJ 18KT00938000) |
| Enumeration Date | 2016-07-05 |
| Last Update Date | 2017-03-03 |