GEORGETOWN ACUPUNCTURE AND HERBS
Ambulatory Health at Austin Ave, Georgetown, TX

License number
Texas AC00922
Category
Ambulatory Health
Type
Clinic/Center
Owner
Name: KENICHI NISHIYA L.AC
Title: MEMBER
Phone: (512) 868-2757
Address
Address
1915 S Austin Ave SUITE 102, Georgetown, TX 78626
National Provider ID: 1447586946
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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GEORGETOWN ACUPUNCTURE AND HERBS, PLLC

Georgetown, TX

Industry:
Health Practitioner's Office
Doing business as:
Georgetown Acupuncture and Herbs, Pllc
Registration:
Jan 5, 2009
Addresses:
1607 S Church St, Georgetown, TX 78626 (Mailing)
1915 S Austin Ave, Georgetown, TX 78626
State ID:
0801070096
Business type:
Domestic Limited Liability Company (LLC)
MANAGING M, Managing Members:
Ashlee Barker Nishiya (MANAGING M, Managing Member), 1607 S Church St, Georgetown, TX 78626,Kenichi Jeremiah Nishiya (MANAGING M, Managing Member), 1607 S Church St, Georgetown, TX 78626
TIN:
32038607811

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