MEDICARE: SUMMIT ACUPUNCTURE INC

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	65000037	OH

General Provider Information

NPI Number	:	1598718488
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUMMIT ACUPUNCTURE INC

Provider Business Mailing Address
First Line	:	1708 MEMMAN RD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44313
Country	:	US
Telephone Number	:	330-929-4334
Fax Number	:	330-929-4353

Provider Business Practice Location Address
First Line	:	1708 MEMMAN RD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44313
Country	:	US
Telephone Number	:	330-929-4334
Fax Number	:	330-929-4353

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. KIRSTEN VANNOSTRAN
Credential	:	LAC
Telephone Number	:	330-929-4334

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	07/22/2020

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