Provider Demographics
NPI:1487062949
Name:APPALACHIAN ACUPUNCTURE
Entity type:Organization
Organization Name:APPALACHIAN ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BOUTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-928-9394
Mailing Address - Street 1:113 E UNAKA AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-4085
Mailing Address - Country:US
Mailing Address - Phone:423-928-9394
Mailing Address - Fax:423-928-9395
Practice Address - Street 1:113 E UNAKA AVE
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-4085
Practice Address - Country:US
Practice Address - Phone:423-928-9394
Practice Address - Fax:423-928-9395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNACU0000000207171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty