Provider Demographics
NPI:1164273645
Name:ACU HERB & TONIC
Entity type:Organization
Organization Name:ACU HERB & TONIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTUIST
Authorized Official - Prefix:
Authorized Official - First Name:ELENI
Authorized Official - Middle Name:
Authorized Official - Last Name:KELAIDIS
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:720-352-1895
Mailing Address - Street 1:PO BOX 370
Mailing Address - Street 2:
Mailing Address - City:MARFA
Mailing Address - State:TX
Mailing Address - Zip Code:79843-0370
Mailing Address - Country:US
Mailing Address - Phone:720-352-1895
Mailing Address - Fax:
Practice Address - Street 1:905 A W SAN ANTONIO NO. 370
Practice Address - Street 2:
Practice Address - City:MARFA
Practice Address - State:TX
Practice Address - Zip Code:79843
Practice Address - Country:US
Practice Address - Phone:720-352-1895
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-01
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty