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General NPI Number Information
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NPI Number | 1861452021
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Entity Type | Individual
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Provider Name | ANDREW J. WEGMAN L.AC. DIPL.AC.
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Gender | Male
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Dates
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Enumeration Date | 03/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 769 S MAIN ST C/O NEW ERA MEDICINE
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City | MANCHESTER
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State | NH
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Zip | 03102-5166
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Country | US
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Telephone | 603-622-8665
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Fax | 603-622-9735
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Provider Business Mailing Address
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Address Line | 726 BEDFORD RD
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City | NEW BOSTON
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State | NH
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Zip | 03070-5113
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Country | US
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Telephone | 617-592-0334
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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 | 50
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License Number State | NH
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 206423
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License Number State | MA
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