MEDICARE: DC ACUPUNCTURE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	305S00000X	Point of Service	AC500090	DC

General Provider Information

NPI Number	:	1033423884
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DC ACUPUNCTURE

Provider Business Mailing Address
First Line	:	1932 35TH PL NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20007-2201
Country	:	US
Telephone Number	:	202-321-2923
Fax Number	:

Provider Business Practice Location Address
First Line	:	1740 WISCONSIN AVE NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20007-2313
Country	:	US
Telephone Number	:	202-321-2923
Fax Number	:	202-333-7667

Authorized Official
Title or Position	:	ACUPUNCTURIST
Name	:	BRONWYN DALTON CLARK
Credential	:	M.AC, L.AC, DIPLAC
Telephone Number	:	202-321-2923

Provider Enumeration Date	:	08/04/2010
Last Update Date	:	04/05/2013

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Directions to “DC ACUPUNCTURE ” Practice Location

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