Provider Demographics
NPI:1366189854
Name:BEACH POINT ACUPUNCTURE, LLC
Entity type:Organization
Organization Name:BEACH POINT ACUPUNCTURE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KRAUSE
Authorized Official - Suffix:
Authorized Official - Credentials:L AC
Authorized Official - Phone:603-998-6507
Mailing Address - Street 1:450 HEFFERON DR
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32084-6516
Mailing Address - Country:US
Mailing Address - Phone:904-679-6739
Mailing Address - Fax:
Practice Address - Street 1:2225 A1A S STE B1
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32080-7906
Practice Address - Country:US
Practice Address - Phone:904-679-6739
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty