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General NPI Number Information
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NPI Number | 1538385307
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Entity Type | Organization
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Legal Business Name | CLASSICAL ACUPUNCTURE
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 321 MAIN ST
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City | GAITHERSBURG
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State | MD
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Zip | 20878-5538
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Country | US
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Telephone | 301-977-7762
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Fax |
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Provider Business Mailing Address
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Address Line | 13333 BONDY WAY
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City | NORTH POTOMAC
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State | MD
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Zip | 20878-2124
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Country | US
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Telephone | 240-604-4519
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURE PRACTITIONER
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Name | MS. REBECCA BOWNE GREENBERG
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Credential | L. AC, M. AC,
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Telephone | 240-604-4519
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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 | U01200
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License Number State | MD
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