Awaken Blossom Foundation

NPI #1659778421 in Oak Park, Illinois

Provider Information

NPI Number: 1659778421
Entity Type: Organization
Organization Name: Awaken Blossom Foundation
Primary Specialty: Acupuncturist
Enumeration Date: Nov 22, 2014
Last Updated: Nov 22, 2014

Practice Location

Address: 6142 ROOSEVELT RD # 101
City: Oak Park
State: Illinois
ZIP Code: 60304-2311
Phone: (708) 613-5690

Authorized Official

Name: MS. MILDRED ABONCE, LMT
Title: VICE-PRESIDENT
Phone: (708) 613-5690

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X
Acupuncturist	171100000X	Primary

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