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General NPI Number Information
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NPI Number | 1588891691
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Entity Type | Organization
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Legal Business Name | ACTUAL SYNERGY CONSULTING
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Dates
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Enumeration Date | 06/16/2009
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Last Update Date | 06/16/2009
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Provider Practice Location Address
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Address Line | 294 PLEASANT ST
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City | STOUGHTON
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State | MA
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Zip | 02072-2571
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Country | US
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Telephone | 781-344-0720
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Fax | 781-344-0891
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Provider Business Mailing Address
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Address Line | 294 PLEASANT ST
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City | STOUGHTON
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State | MA
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Zip | 02072-2571
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Country | US
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Telephone | 781-344-0720
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Fax | 781-344-0891
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. MITZI JOHNSON
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Credential | M.D.
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Telephone | 781-344-0720
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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 |
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License Number State | MA
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