MEDICARE: REBECCA A ALLEN 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	U01412	MD

General Provider Information

NPI Number	:	1518098953
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA A ALLEN L.AC

Provider Business Mailing Address
First Line	:	552 BAILIFF RD
Second Line	:
City	:	NORTH EAST
State	:	MD
Zip	:	21901-2151
Country	:	US
Telephone Number	:	410-287-9110
Fax Number	:

Provider Business Practice Location Address
First Line	:	102B E CECIL AVE
Second Line	:
City	:	NORTH EAST
State	:	MD
Zip	:	21901-4008
Country	:	US
Telephone Number	:	410-287-9110
Fax Number	:

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

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	07/08/2007

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Directions to “ REBECCA A ALLEN L.AC” Practice Location

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