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General NPI Number Information
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NPI Number | 1427903020
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Entity Type | Individual
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Provider Name | JONATHAN MICHAEL PILGRIM LAC
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Gender | Male
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Dates
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Enumeration Date | 02/28/2026
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Last Update Date | 02/28/2026
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Provider Practice Location Address
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Address Line | 125 LITTLE NEW YORK RD
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City | RISING SUN
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State | MD
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Zip | 21911-1932
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Country | US
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Telephone | 410-900-2227
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Fax | 240-540-6166
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Provider Business Mailing Address
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Address Line | 417 ROWLAND DR
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City | PORT DEPOSIT
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State | MD
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Zip | 21904-2203
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Country | US
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Telephone | 443-571-7500
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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 | U03163
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License Number State | MD
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