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General NPI Number Information
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NPI Number | 1861950446
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Entity Type | Individual
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Provider Name | MATTHEW LAWRENCE STAMPE LAC
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Gender | Male
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Dates
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Enumeration Date | 03/04/2019
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Last Update Date | 10/20/2020
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Provider Practice Location Address
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Address Line | 3343 DUKE ST
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City | ALEXANDRIA
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State | VA
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Zip | 22314-5219
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Country | US
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Telephone | 703-259-9193
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Fax |
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Provider Business Mailing Address
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Address Line | 7008 CATLETT ST
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City | SPRINGFIELD
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State | VA
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Zip | 22151-3901
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Country | US
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Telephone | 703-776-0630
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 0019006078
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License Number State | VA
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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 | 0121000941
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC500315
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License Number State | DC
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Taxonomy #4
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | U02615
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License Number State | MD
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