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General NPI Number Information
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NPI Number | 1598229361
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Entity Type | Organization
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Legal Business Name | BLACKSTONE VALLEY ACUPUNCTURE
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Dates
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Enumeration Date | 01/25/2019
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Last Update Date | 01/25/2019
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Provider Practice Location Address
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Address Line | 22 WEST ST STE 5
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City | MILLBURY
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State | MA
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Zip | 01527-2677
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Country | US
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Telephone | 774-276-0568
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Fax |
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Provider Business Mailing Address
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Address Line | 367 MENDON RD
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City | SUTTON
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State | MA
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Zip | 01590-2335
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LISA CAHILL-GREEN
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Credential | LIC. AC.
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Telephone | 774-276-0568
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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 |
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