Provider Demographics
NPI:1730871286
Name:LBA LLC
Entity type:Organization
Organization Name:LBA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFMANN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:215-764-0127
Mailing Address - Street 1:36 LETCHWORTH AVE # 1
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-1735
Mailing Address - Country:US
Mailing Address - Phone:215-764-0127
Mailing Address - Fax:
Practice Address - Street 1:301 OXFORD VALLEY RD # 1404
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-7706
Practice Address - Country:US
Practice Address - Phone:215-764-0127
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty