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General NPI Number Information
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NPI Number | 1770023269
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Entity Type | Organization
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Legal Business Name | WELL ACUPUNTURE INC
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Dates
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Enumeration Date | 03/02/2017
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Last Update Date | 03/02/2017
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Provider Practice Location Address
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Address Line | 42 E CROSS ST LOWER LEVEL
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City | BALTIMORE
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State | MD
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Zip | 21230-4025
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Country | US
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Telephone | 443-600-4329
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Fax |
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Provider Business Mailing Address
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Address Line | 42 E CROSS ST LOWER LEVEL
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City | BALTIMORE
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State | MD
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Zip | 21230-4025
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Country | US
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Telephone | 443-600-4329
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | JENNIFER POULIN
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Credential | LAC., MAC., LMT
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Telephone | 443-600-4329
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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 | U02328
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License Number State | MD
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