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General NPI Number Information
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NPI Number | 1740543313
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Entity Type | Organization
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Legal Business Name | COASTAL ACUPUNCTURE, LLC
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Dates
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Enumeration Date | 06/19/2012
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Last Update Date | 06/19/2012
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Provider Practice Location Address
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Address Line | 18 COASTAL WAY
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City | GREENLAND
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State | NH
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Zip | 03840-2601
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Country | US
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Telephone | 603-433-1727
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Fax | 603-373-0356
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Provider Business Mailing Address
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Address Line | 18 COASTAL WAY
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City | GREENLAND
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State | NH
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Zip | 03840-2601
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Country | US
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Telephone | 603-433-1727
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Fax | 603-373-0356
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Authorized Official
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Title or Position | OWNER
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Name | MS. NETTA M. HART
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Credential | LIC. ACU
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Telephone | 603-433-1727
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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 | 015
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License Number State | NH
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