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General NPI Number Information
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NPI Number | 1568681468
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Entity Type | Individual
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Provider Name | MICHELLE MARIE O'SHAUGHNESSY LICENSED ACUPUNCTURE
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Gender | Female
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 10/07/2011
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Provider Practice Location Address
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Address Line | 32 NORTH 10TH AVE #3
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City | PAGE
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State | AZ
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Zip | 86040
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Country | US
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Telephone | 928-640-0678
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Fax | 407-355-9844
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Provider Business Mailing Address
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Address Line | P.O. BOX 2633
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City | PAGE
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State | AZ
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Zip | 86040
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Country | US
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Telephone | 928-640-0678
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Fax | 407-355-9844
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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 | AP 3223
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License Number State | FL
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