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General NPI Number Information
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NPI Number | 1174172969
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Entity Type | Individual
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Provider Name | COURTNEY ANNE WILHIDE L. AC
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Gender | Female
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Dates
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Enumeration Date | 09/05/2019
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Last Update Date | 09/05/2019
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Provider Practice Location Address
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Address Line | 8701 ANTIETAM DR FL 2
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City | WALKERSVILLE
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State | MD
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Zip | 21793-8020
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Country | US
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Telephone | 301-514-1154
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Fax |
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Provider Business Mailing Address
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Address Line | 601 W 2ND ST
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City | FREDERICK
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State | MD
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Zip | 21701-4830
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Country | US
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Telephone | 301-514-1154
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | U-02285
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License Number State | MD
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