Healthcare Provider Details

I. General information

NPI: 1548358971
Provider Name (Legal Business Name): HELEN NEUMANN LIC ACC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

489 STATE ROAD
WEST TISBURY MA
02575
US

IV. Provider business mailing address

PO BOX 148
CHILMARK MA
02535
US

V. Phone/Fax

Practice location:
  • Phone: 508-693-3800
  • Fax: 508-693-7473
Mailing address:
  • Phone: 508-645-9934
  • Fax: 508-693-7473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number226461
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: