MEDICARE: CHUN S TU LIC. 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
1	171100000X	Acupuncturist	93	MA

General Provider Information

NPI Number	:	1093984445
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHUN S TU LIC. AC.

Provider Business Mailing Address
First Line	:	31 PINE SWAMP RD
Second Line	:
City	:	CUMBERLAND
State	:	RI
Zip	:	02864-1001
Country	:	US
Telephone Number	:	508-399-8880
Fax Number	:

Provider Business Practice Location Address
First Line	:	ACUPUNCTURE CENTER
Second Line	:	668 NEWPORT AVENUE
City	:	S. ATTLEBORO
State	:	MA
Zip	:	02703
Country	:	US
Telephone Number	:	508-399-8880
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/29/2008
Last Update Date	:	02/29/2008

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