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General NPI Number Information
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NPI Number | 1992444764
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Entity Type | Individual
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Provider Name | HEATHER BREE MSOM, LAC
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Gender | Female
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Dates
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Enumeration Date | 05/31/2022
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Last Update Date | 05/31/2022
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Provider Practice Location Address
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Address Line | 620 W LANE ST STE 103
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City | RALEIGH
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State | NC
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Zip | 27603-1441
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Country | US
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Telephone | 919-665-8908
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Fax |
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Provider Business Mailing Address
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Address Line | 2105 PATHWAY DR
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City | CHAPEL HILL
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State | NC
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Zip | 27516-7713
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Country | US
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Telephone | 919-665-8908
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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 | 565
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License Number State | NC
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