Sacred Body Acupuncture and Massage, LLC

NPI #1548530413 in Forest Grove, Oregon

Provider Information

NPI Number: 1548530413
Entity Type: Organization
Organization Name: Sacred Body Acupuncture and Massage, LLC
Primary Specialty: Acupuncturist
Enumeration Date: Jan 9, 2012
Last Updated: Jan 16, 2017

Practice Location

Address: 1904 ELM ST
Address 2: SUITE 4
City: Forest Grove
State: Oregon
ZIP Code: 97116-2553
Phone: (503) 490-4185

Authorized Official

Name: CORINA LEE BRUCKNER, LAC, MACOM
Title: ACUPUNCTURIST, OWNER
Phone: (503) 490-4185

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Acupuncturist	171100000X	Primary

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