Healthcare Provider Details

I. General information

NPI: 1659495547
Provider Name (Legal Business Name): LUCY CB HUTCHISON LIC. AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 BEACON ST SUITE 5 EAST
BROOKLINE MA
02446-5587
US

IV. Provider business mailing address

31 SPRING ST
LEXINGTON MA
02421-7937
US

V. Phone/Fax

Practice location:
  • Phone: 617-416-4144
  • Fax:
Mailing address:
  • Phone: 617-416-4144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number212749
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: