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General NPI Number Information
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NPI Number | 1578069647
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Entity Type | Organization
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Legal Business Name | CENTER FOR CHINESE MEDICINE LLC
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Dates
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Enumeration Date | 04/05/2018
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Last Update Date | 04/05/2018
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Provider Practice Location Address
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Address Line | 2122 P ST NW STE 302
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City | WASHINGTON
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State | DC
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Zip | 20037-1037
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Country | US
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Telephone | 202-257-3287
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Fax |
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Provider Business Mailing Address
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Address Line | 3909 HIGHWOOD CT NW
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City | WASHINGTON
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State | DC
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Zip | 20007-2132
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Country | US
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Telephone | 202-257-3287
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | EDEE CONRAD
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Credential |
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Telephone | 202-257-3287
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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 | 500264
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License Number State | DC
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