MEDICARE: ACUPUNCTURE ENERGETICS, LLC

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	076	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	076	OTHER	NH	ACUPUNCTURE LICENSE

General Provider Information

NPI Number	:	1902024284
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACUPUNCTURE ENERGETICS, LLC

Provider Business Mailing Address
First Line	:	155 LAFAYETTE RD
Second Line	:	BOX 11
City	:	NORTH HAMPTON
State	:	NH
Zip	:	03862-2464
Country	:	US
Telephone Number	:	603-964-9550
Fax Number	:

Provider Business Practice Location Address
First Line	:	155 LAFAYETTE RD
Second Line	:	BOX 11
City	:	NORTH HAMPTON
State	:	NH
Zip	:	03862-2464
Country	:	US
Telephone Number	:	603-964-9550
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	MS. SHERYL L WOOKEY
Credential	:	LIC AC
Telephone Number	:	603-964-9550

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	08/05/2008

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