# BLOSSOM ACUPUNCTURE & WELLNESS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780083550
- **Authorized official:** JENNIE STILES BALDWIN LAC (OWNER/ACUPUNCTURIST)
- **Authorized official phone:** (512) 850-5697

## Contact information

- **Practice address:** 11651 JOLLYVILLE RD STE 150, AUSTIN, TX 78759-4106
- **Practice address phone:** (512) 850-5697
- **Mailing address:** 2008 SIMOND AVE APT D, AUSTIN, TX 78723-4555

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | 01458 | TX | Yes |

## Other

- **Enumeration date:** 08/18/2014
- **Last updated:** 08/18/2014