MEDICARE: MR. JOSEPH JACOB LEVINE L.AC., LMT

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	AC00918	TX

General Provider Information

NPI Number	:	1851620017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOSEPH JACOB LEVINE L.AC., LMT

Provider Business Mailing Address
First Line	:	2312 WESTERN TRAILS BLVD
Second Line	:	#401
City	:	AUSTIN
State	:	TX
Zip	:	78745-1642
Country	:	US
Telephone Number	:	512-300-9032
Fax Number	:

Provider Business Practice Location Address
First Line	:	2312 WESTERN TRAILS BLVD
Second Line	:	#401
City	:	AUSTIN
State	:	TX
Zip	:	78745-1642
Country	:	US
Telephone Number	:	512-300-9032
Fax Number	:

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

Provider Enumeration Date	:	12/17/2009
Last Update Date	:	12/17/2009

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