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General NPI Number Information
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NPI Number | 1730795345
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Entity Type | Organization
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Legal Business Name | DR. MITYA SCHOPPE, DACM, RN, L.AC., PLLC
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Dates
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Enumeration Date | 09/18/2020
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Last Update Date | 09/18/2020
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Provider Practice Location Address
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Address Line | 18 N MAIN ST
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City | WHITE RIVER JUNCTION
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State | VT
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Zip | 05001-7062
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Country | US
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Telephone | 802-456-4581
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Fax |
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Provider Business Mailing Address
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Address Line | 195 SYKES MOUNTAIN AVE UNIT 4472
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City | WHITE RIVER JUNCTION
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State | VT
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Zip | 05001-8243
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Country | US
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Telephone | 802-456-4581
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MITYA SCHOPPE
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Credential | DACM
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Telephone | 802-456-4581
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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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