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General NPI Number Information
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NPI Number | 1568770576
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Entity Type | Individual
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Provider Name | CARIE LEE BERNARD L.AC., DIPL. AC.
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Gender | Female
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Dates
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Enumeration Date | 09/24/2010
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Last Update Date | 09/24/2010
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Provider Practice Location Address
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Address Line | 134 US ROUTE 1
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City | FALMOUTH
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State | ME
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Zip | 04105-2138
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Country | US
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Telephone | 207-409-9779
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Fax |
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Provider Business Mailing Address
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Address Line | 67 GARY L MAIETTA PKWY UNIT 7
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-7819
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Country | US
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Telephone | 207-409-9779
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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 | AC 340
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License Number State | ME
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