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General NPI Number Information
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NPI Number | 1477943926
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Entity Type | Individual
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Provider Name | KATHLEEN BROSNIHAN MACMILLAN L.AC.
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Gender | Female
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Dates
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Enumeration Date | 02/04/2015
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Last Update Date | 02/06/2016
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Provider Practice Location Address
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Address Line | 84 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 | 84 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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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 | 238017
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License Number State | MA
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