| NPI | 1265936561 |
|---|---|
| Doing Business As | BLUE WILLOW ACUPUNCTURE |
| Entity Type | Organization |
| Authorized Contact | LISA MARIE GRAHAM President 267-222-0929 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: PA AK001223) |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2018-03-21 |