MEDICARE: COLUMBUS 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	84000145A	IN

General Provider Information

NPI Number	:	1447627930
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLUMBUS ACUPUNCTURE LLC

Provider Business Mailing Address
First Line	:	2520 CALIFORNIA ST STE G
Second Line	:
City	:	COLUMBUS
State	:	IN
Zip	:	47201-3677
Country	:	US
Telephone Number	:	812-374-4518
Fax Number	:	800-774-0150

Provider Business Practice Location Address
First Line	:	2520 CALIFORNIA ST STE G
Second Line	:
City	:	COLUMBUS
State	:	IN
Zip	:	47201-3677
Country	:	US
Telephone Number	:	812-374-4518
Fax Number	:	800-774-0150

Authorized Official
Title or Position	:	OWNER
Name	:	BRYCE UTT
Credential	:	L.AC.
Telephone Number	:	812-374-4518

Provider Enumeration Date	:	08/31/2015
Last Update Date	:	08/23/2024

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Directions to “COLUMBUS ACUPUNCTURE LLC ” Practice Location

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