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General NPI Number Information
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NPI Number | 1902283062
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Entity Type | Organization
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Legal Business Name | STRATFORD ACUPUNCTURE & WELLNESS CENTER
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Dates
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Enumeration Date | 04/28/2015
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Last Update Date | 04/28/2015
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Provider Practice Location Address
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Address Line | 95 ARMORY RD
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City | STRATFORD
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State | CT
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Zip | 06614-1753
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Country | US
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Telephone | 203-257-7550
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Fax | 888-941-0005
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Provider Business Mailing Address
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Address Line | 95 ARMORY RD
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City | STRATFORD
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State | CT
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Zip | 06614-1753
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Country | US
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Telephone | 203-257-7550
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Fax | 888-941-0005
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Authorized Official
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Title or Position | OWNER
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Name | JOSEPH DOWNER
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Credential | LAC
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Telephone | 203-257-7550
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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 | 534
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License Number State | CT
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