MEDICARE: BRAASCH ACUPUNCTURE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	OM000161	PA

General Provider Information

NPI Number	:	1043696628
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRAASCH ACUPUNCTURE, LLC

Provider Business Mailing Address
First Line	:	1817 MURDOCH RD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15217-1531
Country	:	US
Telephone Number	:	412-400-8135
Fax Number	:	888-977-9201

Provider Business Practice Location Address
First Line	:	2301 MURRAY AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15217-2355
Country	:	US
Telephone Number	:	412-400-8135
Fax Number	:	888-977-9201

Authorized Official
Title or Position	:	OWNER
Name	:	PETER ANTHONY BRAASCH
Credential	:	L.AC.
Telephone Number	:	412-400-8135

Provider Enumeration Date	:	08/05/2015
Last Update Date	:	08/05/2015

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