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General NPI Number Information
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NPI Number | 1124645023
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Entity Type | Organization
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Legal Business Name | WATERFRONT ACUPUNCTURE & WELLNESS, LLC
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Dates
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Enumeration Date | 06/26/2020
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Last Update Date | 06/26/2020
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Provider Practice Location Address
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Address Line | 225 WATER ST STE B239
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City | PLYMOUTH
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State | MA
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Zip | 02360-4080
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Country | US
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Telephone | 508-685-9556
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Fax |
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Provider Business Mailing Address
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Address Line | 225 WATER ST STE B239
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City | PLYMOUTH
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State | MA
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Zip | 02360-4080
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Country | US
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Telephone | 508-685-9556
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Fax |
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Authorized Official
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Title or Position | OWNER, ACUPUNCTURIST
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Name | ALEXANDRA ANDREW
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Credential | MS, L.AC.
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Telephone | 508-287-5529
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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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