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NPI Code Detail

MEDICARE: NICOLE LAFOUNTAIN LA.C

MEDICARE: NICOLE LAFOUNTAIN LA.C
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
1171100000XAcupuncturistMAP.335SC

General Provider Information

NPI Number : 1427640432
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE LAFOUNTAIN LA.C
Provider Business Mailing Address
First Line : 711 SAINT ANDREWS BLVD
Second Line :
City : CHARLESTON
State : SC
Zip : 29407-7196
Country : US
Telephone Number : 843-937-6890
Fax Number :
Provider Business Practice Location Address
First Line : 711 SAINT ANDREWS BLVD
Second Line :
City : CHARLESTON
State : SC
Zip : 29407-7196
Country : US
Telephone Number : 843-937-6890
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2021
Last Update Date : 02/10/2021

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Directions to “ NICOLE LAFOUNTAIN LA.C” Practice Location

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