Healthcare Provider Details

I. General information

NPI: 1104312610
Provider Name (Legal Business Name): INNERSPRING ACUPUNCTURE & WELLBEING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2018
Last Update Date: 08/22/2024
Certification Date: 08/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

132 GREAT RD STE 201
STOW MA
01775-1189
US

IV. Provider business mailing address

132 GREAT RD STE 201
STOW MA
01775-1189
US

V. Phone/Fax

Practice location:
  • Phone: 978-461-2001
  • Fax: 866-709-1684
Mailing address:
  • Phone: 978-461-2001
  • Fax: 866-709-1684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number230194
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. GEORGE MANDLER
Title or Position: PRESIDENT
Credential: LDN LICAC DACM
Phone: 978-461-2001