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General NPI Number Information
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NPI Number | 1871916601
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Entity Type | Organization
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Legal Business Name | ATLAS ACUPUNCTURE
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Dates
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Enumeration Date | 01/30/2014
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Last Update Date | 01/30/2014
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Provider Practice Location Address
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Address Line | 431 PINE ST SUITE 312
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City | BURLINGTON
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State | VT
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Zip | 05401-4726
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Country | US
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Telephone | 802-448-0727
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Fax |
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Provider Business Mailing Address
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Address Line | 431 PINE ST SUITE 312
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City | BURLINGTON
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State | VT
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Zip | 05401-4726
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Country | US
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Telephone | 802-448-0727
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST, HERBALIST
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Name | MONTANA BURNS
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Credential | B.S., M.S.O.M., L.AC
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Telephone | 208-720-8386
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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 | 091.0100355
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License Number State | VT
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