MEDICARE: DONNA L FORTI 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	225	MA

General Provider Information

NPI Number	:	1699843425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA L FORTI LIC. AC.

Provider Business Mailing Address
First Line	:	107 GEORGE HILL RD
Second Line	:
City	:	GRAFTON
State	:	MA
Zip	:	01519-1416
Country	:	US
Telephone Number	:	508-839-0415
Fax Number	:

Provider Business Practice Location Address
First Line	:	107 GRAFTON HILL ROAD
Second Line	:
City	:	GRAFTON
State	:	MA
Zip	:	01519
Country	:	US
Telephone Number	:	508-839-0415
Fax Number	:

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

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	07/08/2007

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