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Organization

TDETH 1,LLC

Active
Other names
Modern Acupuncture
Organization subpart
No

Provider details

NPI number
Authorized official
TOM ETHEREDGE (FRANCHISE OWNER)
(512) 599-4506
Entity
Organization

Contact information

Practice address
9722 GREAT HILLS TRL STE 125, AUSTIN, TX 78759-7265
(512) 239-8223
Mailing address
7905 GRIFFIN CT, AUSTIN, TX 78731-1910
(512) 599-4506

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary

Other

Enumeration date
09/16/2020
Last updated
01/14/2021
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