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General NPI Number Information
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NPI Number | 1619306743
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Entity Type | Individual
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Provider Name | CARLA L SANDIEGO L.AC.
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Gender | Female
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Dates
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Enumeration Date | 11/08/2013
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 130 CENTRAL AVE STE 2C
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City | DOVER
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State | NH
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Zip | 03820-4042
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Country | US
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Telephone | 603-684-2413
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Fax | 603-750-9136
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Provider Business Mailing Address
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Address Line | 130 CENTRAL AVE STE 2C
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City | DOVER
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State | NH
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Zip | 03820-4042
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Country | US
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Telephone | 603-684-2413
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Fax | 603-750-9136
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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 | 000783
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 25MZ00102700
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 337
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License Number State | NH
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