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General NPI Number Information
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NPI Number | 1922247865
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Entity Type | Organization
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Legal Business Name | CONCORD CENTER ACUPUNCTURE
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Dates
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Enumeration Date | 02/17/2009
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Last Update Date | 02/17/2009
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Provider Practice Location Address
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Address Line | 91 MAIN ST STE 201
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City | CONCORD
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State | MA
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Zip | 01742-2571
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Country | US
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Telephone | 978-369-9400
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Fax | 978-369-9400
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Provider Business Mailing Address
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Address Line | 91 MAIN ST STE 201
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City | CONCORD
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State | MA
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Zip | 01742-2571
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Country | US
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Telephone | 978-369-9400
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Fax | 978-369-9400
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Authorized Official
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Title or Position | CO-OWNER, LICENSED ACUPUNCTURIST
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Name | MICHELLE N. SOUCY
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Credential | LIC. AC., MAOM
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Telephone | 978-369-9400
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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 | 230158
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License Number State | MA
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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 | 230159
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License Number State | MA
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