Organization
SPORTLAND ACUPUNCTURE LLC
Active
Other names
Sportland Acupuncture
Organization subpart
No
Provider details
NPI number
Authorized official
GENEVIEVE MOORE RENAE MOORE LAC (ACUPUNCTURIST)
(503) 679-3872
Entity
Organization
Contact information
Practice address
1025 N HUMBOLDT, PORTLAND, OR 97217
(503) 679-3872
Mailing address
1025 N HUMBOLDT, PORTLAND, OR 97217
(503) 679-3872
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC156421
OR
Other
Enumeration date
09/12/2012
Last updated
09/12/2012
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