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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