Healthcare Provider Details

I. General information

NPI: 1013615921
Provider Name (Legal Business Name): POINTS EAST ACUPUNCTURE AND HEALING ARTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2023
Last Update Date: 06/05/2023
Certification Date: 06/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 RIVER ST
WINDSOR VT
05089-1445
US

IV. Provider business mailing address

5 RIVER ST
WINDSOR VT
05089-1445
US

V. Phone/Fax

Practice location:
  • Phone: 802-291-3236
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: MARK MAMUSZKA
Title or Position: MANAGING MEMBER
Credential: LAC
Phone: 802-291-3236