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General NPI Number Information
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NPI Number | 1992907877
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Entity Type | Individual
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Provider Name | EDITH PELS LIC. AC.
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Gender | Female
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Dates
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Enumeration Date | 06/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 212 COMMERCIAL ST # 1
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City | PROVINCETOWN
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State | MA
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Zip | 02657-2134
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Country | US
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Telephone | 508-487-2400
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1502 1
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City | PROVINCETOWN
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State | MA
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Zip | 02657-5502
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Country | US
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Telephone | 508-487-2400
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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 | 213807
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License Number State | MA
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