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General NPI Number Information
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NPI Number | 1518461458
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Entity Type | Organization
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Legal Business Name | AUTHENTIC ACUPUNCTURE & FAMILY WELLNESS
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Dates
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Enumeration Date | 03/23/2018
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Last Update Date | 03/23/2018
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Provider Practice Location Address
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Address Line | 28 S HARRISON ST
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City | EASTON
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State | MD
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Zip | 21601-3019
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Country | US
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Telephone | 570-730-2304
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Fax |
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Provider Business Mailing Address
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Address Line | 28 S HARRISON ST
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City | EASTON
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State | MD
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Zip | 21601-3019
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Country | US
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Telephone | 570-730-2304
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR/ACUPUNCTURIST
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Name | CAROLINE WRIGHTSON
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Credential | L.AC., DIPL. AC.
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Telephone | 570-730-2304
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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 | U02365
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License Number State | MD
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