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General NPI Number Information
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NPI Number | 1083257828
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Entity Type | Organization
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Legal Business Name | KM ACUPUNCTURE, PLLC
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Dates
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Enumeration Date | 10/24/2019
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Last Update Date | 10/24/2019
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Provider Practice Location Address
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Address Line | 82A UNDERPASS RD
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City | BREWSTER
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State | MA
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Zip | 02631-1809
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Country | US
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Telephone | 774-216-4149
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Fax | 508-974-3340
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Provider Business Mailing Address
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Address Line | 102 HOPKINS LN
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City | ORLEANS
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State | MA
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Zip | 02653-3415
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Country | US
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Telephone | 508-627-2118
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Fax | 508-974-3340
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Authorized Official
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Title or Position | OWNER
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Name | KATHLEEN B MACMILLAN
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Credential | LIC.AC.
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Telephone | 508-627-2118
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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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