Organization
ARDENT LIVING ACUPUNCTURE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOBIAS D DONAKER C.A. (OWNER)
(217) 622-4845
Entity
Organization
Contact information
Practice address
4710 E BROADWAY STE 190, MADISON, WI 53716-4105
(217) 622-4845
Mailing address
933 E JOHNSON ST, MADISON, WI 53703-1621
(217) 622-4845
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
794-55
WI
Other
Enumeration date
08/06/2013
Last updated
08/06/2013
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