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Organization
GARDEN STATE ACUPUNCTURE AND WELLNESS
Active
Organization
GARDEN STATE ACUPUNCTURE AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN CLARK DAOM, L.AC. (OWNER)
(302) 249-0143
Entity
Organization
Contact information
Practice address
415 ROUTE 34, SUITE 210, COLTS NECK, NJ 07722-2522
(302) 249-0143
(732) 775-3515
Mailing address
1116 5TH AVE, ASBURY PARK, NJ 07712-4905
(302) 249-0143
(732) 775-3515
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
25MZ00104200
NJ
225700000X
Massage Therapist
18KT00938000
NJ
Other
Enumeration date
07/05/2016
Last updated
03/03/2017
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