Organization
GEORGETOWN ACUPUNCTURE AND HERBS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENICHI NISHIYA L.AC (MEMBER)
(512) 868-2757
Entity
Organization
Contact information
Practice address
1915 S AUSTIN AVE, SUITE 102, GEORGETOWN, TX 78626-7843
(512) 868-2757
Mailing address
1915 S AUSTIN AVE, SUITE 102, GEORGETOWN, TX 78626-7843
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
AC00922
TX
Other
Enumeration date
10/19/2009
Last updated
10/19/2009
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