# EASTERN ACUPUNCTURE WILTON MANORS

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** EASTERN ACUPUNCTURE AND WELLNESS
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1316608714
- **Legal business name:** EASTERN ACUPUNCTURE AND WELLNESS
- **Authorized official:** JENNIFER CRUZ AP.DAOM (PHYSICIAN)
- **Authorized official phone:** (954) 400-5044

## Contact information

- **Practice address:** 1201 NE 26TH ST STE 106, WILTON MANORS, FL 33305-1206
- **Practice address phone:** (954) 400-5044
- **Mailing address:** 13224 W BROWARD BLVD, PLANTATION, FL 33325-2228
- **Mailing address phone:** (954) 400-5504
- **Mailing address fax:** (954) 400-5503

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | — | — | Yes |

## Other

- **Enumeration date:** 01/07/2022
- **Last updated:** 01/07/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1235397910 | ACUPUNCTURIST | FL |