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NPI Code Detail

MEDICARE: JACQUELYN LUCILLE GEORGE L.AC.

MEDICARE: JACQUELYN LUCILLE GEORGE L.AC.
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
1171100000XAcupuncturistAC329ME

General Provider Information

NPI Number : 1053543694
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELYN LUCILLE GEORGE L.AC.
Provider Business Mailing Address
First Line : 165 FOREST LAKE RD
Second Line :
City : FRIENDSHIP
State : ME
Zip : 04547-4205
Country : US
Telephone Number : 207-542-4737
Fax Number :
Provider Business Practice Location Address
First Line : 7 LIMEROCK ST
Second Line :
City : ROCKLAND
State : ME
Zip : 04841-2928
Country : US
Telephone Number : 207-542-4737
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2009
Last Update Date : 08/16/2009

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Directions to “ JACQUELYN LUCILLE GEORGE L.AC.” Practice Location

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