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General NPI Number Information
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NPI Number | 1578900262
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Entity Type | Organization
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Legal Business Name | PO CHI LAM CLINIC INC
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Dates
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Enumeration Date | 06/04/2013
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Last Update Date | 06/04/2013
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Provider Practice Location Address
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Address Line | 83 BOSTON POST RD
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City | WATERFORD
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State | CT
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Zip | 06385-2423
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Country | US
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Telephone | 860-443-0800
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Fax |
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Provider Business Mailing Address
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Address Line | 224 BROADWAY FL 1
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City | NORWICH
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State | CT
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Zip | 06360-4331
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Country | US
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Telephone | 860-425-0774
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Fax |
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Authorized Official
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Title or Position | SECRETARY/TREASURER
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Name | GALE E TALMADGE
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Credential |
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Telephone | 860-425-0774
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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 | 532
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License Number State | CT
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