Basic Information
| Provider Information | |||||||||
| NPI: | 1689070518 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ACU AT TOMS LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2328 10TH AVE N STE 302 | ||||||||
| Address2: | |||||||||
| City: | LAKE WORTH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334616612 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5613184411 | ||||||||
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| Practice Location | |||||||||
| Address1: | 16 WHITESVILLE RD | ||||||||
| Address2: | |||||||||
| City: | TOMS RIVER | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 087534107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8884433869 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/04/2014 | ||||||||
| LastUpdateDate: | 11/04/2014 | ||||||||
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| AuthorizedOfficialLastName: | AITKEN | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
| AuthorizedOfficialMiddleName: | STOKES | ||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF OPERATING OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 5613184411 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171100000X | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Acupuncturist |
No ID Information.