National Provider Identifier Database

GEORGIA KETAMINE RENEW
Acupuncturist

An acupuncturist is a person who performs ancient therapy for alleviation of pain, anesthesia and treatment of some diseases. Acupuncturists use long, fine needles inserted into specific points in order to treat painful conditions or produce anesthesia.


Contact Information

GEORGIA KETAMINE RENEW
1370 THOMPSON BRIDGE RD STE 101
GAINESVILLE, GA30501-1780
Phone: 678-769-7008
Fax:
Website:
Specialty Taxonomy Code
* Acupuncturist 171100000X
Medical Specialty 261QM2500X

* Indicates primary specialty

NPI Profile & details for GEORGIA KETAMINE RENEW

NPI Number 1255951182
Legal business name
LBN
GEORGIA KETAMINE RENEW
Authorized official HEIDI NICHOLSON - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 04/21/2020
Last updated 04/21/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • GA Other: 34210 LICENSE

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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