=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013553171
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MAEGAN DAVIS L.AC., DIPL. O.M .
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/25/2019
-----------------------------------------------------
Last Update Date | 11/25/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 372 DEPOT ST STE 20
-----------------------------------------------------
City | ASHEVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28801-4370
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-407-0412
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 17 OAK HILL LN
-----------------------------------------------------
City | FAIRVIEW
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28730-9726
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-351-8716
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | NC1017
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------