Healthcare Provider Details

I. General information

NPI: 1154242865
Provider Name (Legal Business Name): HOMETOWN ACUPUNCTURE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

143 MITCHELLS CHANCE RD
EDGEWATER MD
21037-2773
US

IV. Provider business mailing address

100 FIDDLERS HILL RD
EDGEWATER MD
21037-3613
US

V. Phone/Fax

Practice location:
  • Phone: 772-643-4468
  • Fax:
Mailing address:
  • Phone: 772-643-4468
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JOSHUA DAVID ELLIOTT
Title or Position: ACUPUNCTURIST
Credential: LAC
Phone: 772-643-4468