Healthcare Provider Details

I. General information

NPI: 1063720308
Provider Name (Legal Business Name): ALISON HOPE BEARD L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2010
Last Update Date: 09/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 BULL ST
COLUMBIA SC
29201-2556
US

IV. Provider business mailing address

1920 BULL ST
COLUMBIA SC
29201-2556
US

V. Phone/Fax

Practice location:
  • Phone: 803-806-8889
  • Fax: 803-806-8893
Mailing address:
  • Phone: 803-806-8889
  • Fax: 803-806-8893

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberTL156
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: