Organization
ORIENTAL MEDICINE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PHEBE SOON PURNELL ALC (OWNER)
(262) 691-8888
Entity
Organization
Contact information
Practice address
W249 N5245 EXECUTIVE DR., SUITE 208, SUSSEX, WI 53089
(262) 691-8888
Mailing address
W249 N5245 EXECUTIVE DR., SUITE 208, SUSSEX, WI 53089
(262) 691-8888
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
684-055
WI
Other
Enumeration date
01/20/2015
Last updated
01/25/2017
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