Organization
IN LIGHT ACUPUNCTURE & HERBOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHUONG TT NGO (MGR)
(727) 698-6391
Entity
Organization
Contact information
Practice address
1801 BAYOU GRANDE BLVD NE, ST PETERSBURG, FL 33703-1909
(727) 698-6391
Mailing address
1801 BAYOU GRANDE BLVD NE, ST PETERSBURG, FL 33703-1909
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
AP3479
FL
Other
Enumeration date
07/18/2017
Last updated
07/18/2017
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