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Organization

ON THE GO ACUPUNCTURE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LESLEY IKE (OWNER)
(954) 668-4002
Entity
Organization

Contact information

Practice address
3030 NE 21ST TER, 8, FT LAUDERDALE, FL 33306-1251
(954) 668-4002
Mailing address
3030 NE 21ST TER, 8, FT LAUDERDALE, FL 33306-1251
(954) 668-4002

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
AP3395
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
AP3395
ACUPUNCTURIST
FL
Enumeration date
02/16/2015
Last updated
02/16/2015
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