MEDICARE: KIMARIE CALHOUN LAC

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

General Provider Information

NPI Number	:	1366083370
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMARIE CALHOUN LAC

Provider Business Mailing Address
First Line	:	12523 ATHERTON DR
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20906-4332
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12523 ATHERTON DR
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20906-4332
Country	:	US
Telephone Number	:	240-752-8675
Fax Number	:

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

Provider Enumeration Date	:	10/01/2019
Last Update Date	:	10/01/2019

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Directions to “ KIMARIE CALHOUN LAC” Practice Location

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