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NPI Code Detail

MEDICARE: CHARLEEN LYNN WHIPPLE L.AC

MEDICARE: CHARLEEN LYNN WHIPPLE 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
1171100000XAcupuncturistAC01573TX

General Provider Information

NPI Number : 1255692380
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLEEN LYNN WHIPPLE L.AC
Provider Business Mailing Address
First Line : 111 E OLD SETTLERS BLVD
Second Line :
City : ROUND ROCK
State : TX
Zip : 78664-2211
Country : US
Telephone Number : 512-763-0616
Fax Number :
Provider Business Practice Location Address
First Line : 111 E OLD SETTLERS BLVD
Second Line :
City : ROUND ROCK
State : TX
Zip : 78664-2211
Country : US
Telephone Number : 512-763-0616
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2012
Last Update Date : 01/22/2016

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Directions to “ CHARLEEN LYNN WHIPPLE L.AC” Practice Location

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