Organization
PROACTIVE WELLNESS,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE ELIZABETH WALSH L.AC (BUSINESS OWNER)
(609) 234-0617
Entity
Organization
Contact information
Practice address
230 N MAPLE AVE, MARLTON, NJ 08053-9400
(856) 983-5422
Mailing address
10 HASTINGS CT, MARLTON, NJ 08053-5332
(609) 234-0617
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
25MZ00089700
NJ
Other
Enumeration date
09/26/2013
Last updated
10/02/2013
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