MEDICARE: MR. KIM BONSTEEL 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
1	171100000X	Acupuncturist	564	NC
2	174H00000X	Health Educator
3	175F00000X	Naturopath
4	225700000X	Massage Therapist	4091	NC

General Provider Information

NPI Number	:	1164731741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KIM BONSTEEL L.AC.

Provider Business Mailing Address
First Line	:	PO BOX 304
Second Line	:
City	:	SAPPHIRE
State	:	NC
Zip	:	28774-0304
Country	:	US
Telephone Number	:	828-526-0743
Fax Number	:	828-862-3335

Provider Business Practice Location Address
First Line	:	348 S 5TH ST # 224
Second Line	:
City	:	HIGHLANDS
State	:	NC
Zip	:	28741-7002
Country	:	US
Telephone Number	:	828-526-0743
Fax Number	:	828-862-3335

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

Provider Enumeration Date	:	09/30/2010
Last Update Date	:	09/30/2010

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