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General NPI Number Information
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NPI Number | 1669634804
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Entity Type | Individual
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Provider Name | ANSON CRAWFORD RATHBONE LIC AC
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Gender | Male
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Dates
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Enumeration Date | 06/30/2008
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Last Update Date | 10/03/2011
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Provider Practice Location Address
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Address Line | 661 SALEM ST
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City | MALDEN
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State | MA
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Zip | 02148-4301
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Country | US
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Telephone | 617-924-3945
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Fax | 781-324-2640
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Provider Business Mailing Address
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Address Line | 77 BRENTWOOD ST
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City | MALDEN
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State | MA
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Zip | 02148-4737
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Country | US
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Telephone | 617-697-5723
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Fax | 781-324-2640
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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 |
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License Number State |
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