MEDICARE: SUSAN A TODD LIC. 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	376	MA

General Provider Information

NPI Number	:	1477732824
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN A TODD LIC. AC.

Provider Business Mailing Address
First Line	:	22 BEACON ST
Second Line	:
City	:	WEST BRIDGEWATER
State	:	MA
Zip	:	02379-1418
Country	:	US
Telephone Number	:	508-587-2693
Fax Number	:

Provider Business Practice Location Address
First Line	:	455 W CENTER ST # A
Second Line	:
City	:	WEST BRIDGEWATER
State	:	MA
Zip	:	02379-1637
Country	:	US
Telephone Number	:	508-587-2693
Fax Number	:

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

Provider Enumeration Date	:	11/01/2007
Last Update Date	:	11/01/2007

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