MEDICARE: SAMANTHA MAREK 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	65.000316	OH

General Provider Information

NPI Number	:	1548620347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA MAREK L.AC.

Provider Business Mailing Address
First Line	:	470 AMESBURY DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43230-2370
Country	:	US
Telephone Number	:	614-598-5760
Fax Number	:

Provider Business Practice Location Address
First Line	:	830 E JOHNSTOWN RD
Second Line	:	SUITE C
City	:	GAHANNA
State	:	OH
Zip	:	43230-3815
Country	:	US
Telephone Number	:	614-584-7989
Fax Number	:

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

Provider Enumeration Date	:	03/07/2016
Last Update Date	:	03/07/2016

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Directions to “ SAMANTHA MAREK L.AC.” Practice Location

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