Healthcare Provider Details

I. General information

NPI: 1003466475
Provider Name (Legal Business Name): OMD ACUPUNCTURE &HERBAL CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2019
Last Update Date: 09/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10760 HICKORY RIDGE RD STE 117
COLUMBIA MD
21044-3682
US

IV. Provider business mailing address

3640 CHATHAM RD
ELLICOTT CITY MD
21042-3926
US

V. Phone/Fax

Practice location:
  • Phone: 410-299-9666
  • Fax: 410-465-5289
Mailing address:
  • Phone: 410-299-9666
  • Fax: 410-465-5289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: MS. MAY HSIA
Title or Position: OWNER
Credential: LAC
Phone: 410-299-9666