Healthcare Provider Details

I. General information

NPI: 1881086262
Provider Name (Legal Business Name): ANTHONY FELAN SAENZ LAC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2015
Last Update Date: 03/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 SAINT JOHN ST FL 1
HAVRE DE GRACE MD
21078-2817
US

IV. Provider business mailing address

330 SAINT JOHN ST FL 1
HAVRE DE GRACE MD
21078-2817
US

V. Phone/Fax

Practice location:
  • Phone: 443-739-4158
  • Fax: 410-939-0219
Mailing address:
  • Phone: 443-739-4158
  • Fax: 410-939-0219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberU02181
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: