Organization
PLUMERIA ACUPUNCTURE AND HOLISTIC WELLNESS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AYAKO MIZUNO DAOM (OWNER)
(414) 687-0087
Entity
Organization
Contact information
Practice address
2500 N MAYFAIR RD, WAUWATOSA, WI 53226-1409
(414) 687-0087
Mailing address
2500 N MAYFAIR RD STE 410, WAUWATOSA, WI 53226-1415
(414) 687-0087
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1002-55
LICENSED ACUPUNCTURIST
WI
Enumeration date
01/29/2021
Last updated
02/04/2021
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