Healthcare Provider Details
I. General information
NPI: 1538593777
Provider Name (Legal Business Name): FAITH MICHELLE LESHNER MELTZER LAC, LOM, DIPLO, DAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/23/2013
Last Update Date: 01/01/2022
Certification Date: 07/09/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6 S SYCAMORE ST
NEWTOWN PA
18940-1533
US
IV. Provider business mailing address
59 PORTSMOUTH CT
SOUTHAMPTON PA
18966-2621
US
V. Phone/Fax
- Phone: 267-968-1479
- Fax: 267-274-9179
- Phone: 267-968-1478
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | AK001091 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: