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General NPI Number Information
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NPI Number | 1629695853
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Entity Type | Individual
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Provider Name | DEAN ELEFTHERAKIS L.AC. DIPL. OM
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Gender | Male
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Dates
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Enumeration Date | 07/03/2020
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Last Update Date | 10/08/2020
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Provider Practice Location Address
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Address Line | 503 SUNSET DR.
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City | DICKSON CITY
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State | PA
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Zip | 18447
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Country | US
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Telephone | 570-507-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 1340 CHARLES RD
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City | JEFFERSON TOWNSHIP
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State | PA
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Zip | 18436-3415
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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 |
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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 | AK001325
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License Number State | PA
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