MEDICARE: LINA MARIA CASTILLA L.AC.

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	U01761	MD

General Provider Information

NPI Number	:	1407088834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINA MARIA CASTILLA L.AC.

Provider Business Mailing Address
First Line	:	2209 ROGENE DR
Second Line	:	101
City	:	BALTIMORE
State	:	MD
Zip	:	21209-3441
Country	:	US
Telephone Number	:	443-904-6687
Fax Number	:

Provider Business Practice Location Address
First Line	:	1014 DULANEY VALLEY RD
Second Line	:
City	:	TOWSON
State	:	MD
Zip	:	21204-2702
Country	:	US
Telephone Number	:	443-904-6687
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2009
Last Update Date	:	08/18/2009

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