Healthcare Provider Details

I. General information

NPI: 1962742445
Provider Name (Legal Business Name): ELIZABETH DEERING ELZEY L. AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2013
Last Update Date: 02/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2704 GREENVILLE HWY SUITE B
FLAT ROCK NC
28731-0446
US

IV. Provider business mailing address

186 MCDOWELL RD
MILLS RIVER NC
28759-2545
US

V. Phone/Fax

Practice location:
  • Phone: 828-698-5225
  • Fax:
Mailing address:
  • Phone: 828-301-7684
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number708
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: