Healthcare Provider Details

I. General information

NPI: 1538221668
Provider Name (Legal Business Name): TIMOTHY E O'BRIEN D.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2006
Last Update Date: 12/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 NOOSENECK HILL RD OPUS ACUPUNCTURE
WEST GREENWICH RI
02817-1523
US

IV. Provider business mailing address

PO BOX 837 OPUS ACUPUNCTURE
WYOMING RI
02898
US

V. Phone/Fax

Practice location:
  • Phone: 401-397-6333
  • Fax:
Mailing address:
  • Phone: 401-397-6333
  • Fax: 401-397-3124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberDA00149
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: