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General NPI Number Information
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NPI Number | 1033811476
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Entity Type | Organization
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Legal Business Name | CARRIE DURKEE ACUPUNCTURE, LLC
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Dates
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Enumeration Date | 03/20/2023
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Last Update Date | 03/20/2023
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Provider Practice Location Address
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Address Line | 10806 REISTERSTOWN RD STE 1B
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City | OWINGS MILLS
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State | MD
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Zip | 21117-2700
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Country | US
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Telephone | 410-925-2126
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Fax |
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Provider Business Mailing Address
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Address Line | 3604 STEWART LN
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City | HAMPSTEAD
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State | MD
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Zip | 21074-1758
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Country | US
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Telephone | 410-925-2126
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CARRIE DURKEE IMMLER
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Credential | L.AC. M.AC.
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Telephone | 410-925-2126
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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