Healthcare Provider Details

I. General information

NPI: 1518749563
Provider Name (Legal Business Name): MARCELLA K HAMMOND LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2023
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7475 MINERAL POINT RD STE 113
MADISON WI
53717-1720
US

IV. Provider business mailing address

7475 MINERAL POINT RD STE 113
MADISON WI
53717-1720
US

V. Phone/Fax

Practice location:
  • Phone: 608-284-8771
  • Fax:
Mailing address:
  • Phone: 608-284-8771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number907-55
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: