Healthcare Provider Details

I. General information

NPI: 1659682599
Provider Name (Legal Business Name): MARCIA PORTER GRIFFITH BOWER MAOM, L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARCIA PORTER GRIFFITH MAOM, LIC.AC.

II. Dates (important events)

Enumeration Date: 06/25/2010
Last Update Date: 04/25/2022
Certification Date: 04/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 MILLER RD STE 600
CASTLETON NY
12033-4042
US

IV. Provider business mailing address

81 MILLER RD STE 600
CASTLETON NY
12033-4042
US

V. Phone/Fax

Practice location:
  • Phone: 518-336-6482
  • Fax:
Mailing address:
  • Phone: 518-336-6482
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: