Provider Demographics
NPI:1366258469
Name:TENDING ROOTS ACUPUNCTURE LLC
Entity type:Organization
Organization Name:TENDING ROOTS ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:KORENKIEWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:207-838-0469
Mailing Address - Street 1:75 WOODLAND SHORE DR
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04274-6113
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:67 SHAKER RD STE 8A
Practice Address - Street 2:
Practice Address - City:GRAY
Practice Address - State:ME
Practice Address - Zip Code:04039-9640
Practice Address - Country:US
Practice Address - Phone:207-838-0469
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty