| NPI | 1710489331 |
|---|---|
| Former Legal Business Name | LONGVILLEACU |
| Entity Type | Organization |
| Authorized Contact | LEONIE WIMS Owner 954-769-0946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171100000X Acupuncturist (Licence: FL AP3878) |
| Enumeration Date | 2018-02-28 |
| Last Update Date | 2021-04-27 |