MEDICARE: MAGGIE ROSE GARRETT 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	11291	CA

General Provider Information

NPI Number	:	1770784241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAGGIE ROSE GARRETT L. AC.

Provider Business Mailing Address
First Line	:	137 W EL ROBLAR DR
Second Line	:
City	:	OJAI
State	:	CA
Zip	:	93023-2208
Country	:	US
Telephone Number	:	805-421-6032
Fax Number	:	805-624-6106

Provider Business Practice Location Address
First Line	:	137 W EL ROBLAR DR
Second Line	:
City	:	OJAI
State	:	CA
Zip	:	93023-2208
Country	:	US
Telephone Number	:	805-421-6032
Fax Number	:	805-624-6106

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

Provider Enumeration Date	:	05/30/2007
Last Update Date	:	09/01/2009

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