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General NPI Number Information
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NPI Number | 1336687235
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Entity Type | Organization
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Legal Business Name | MEDICAL ACUPUNCTURE CLINIC OF PITTSBURGH LLC
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Dates
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Enumeration Date | 02/10/2017
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Last Update Date | 03/10/2017
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Provider Practice Location Address
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Address Line | 1350 OLD FREEPORT RD STE 2A
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City | PITTSBURGH
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State | PA
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Zip | 15238-3122
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Country | US
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Telephone | 724-991-2366
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Fax |
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Provider Business Mailing Address
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Address Line | 2762 MCMORRAN RD
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City | GIBSONIA
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State | PA
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Zip | 15044-9487
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARIEVIC G MANRIQUE
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Credential | M.D.
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Telephone | 412-926-5844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | MD073180L
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License Number State | PA
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