Healthcare Provider Details

I. General information

NPI: 1437387339
Provider Name (Legal Business Name): MARYANNE LINDER L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2009
Last Update Date: 06/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3070 RIVERSIDE DR SUITE 160
COLUMBUS OH
43221-2547
US

IV. Provider business mailing address

3070 RIVERSIDE DR SUITE 160
COLUMBUS OH
43221-2547
US

V. Phone/Fax

Practice location:
  • Phone: 614-487-0874
  • Fax:
Mailing address:
  • Phone: 614-487-0874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number65.000086
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: