MEDICARE: OLGA O ORRACA 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	2012	NC

General Provider Information

NPI Number	:	1639776362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OLGA O ORRACA L.AC

Provider Business Mailing Address
First Line	:	6260 RIVERWOODS DR APT 205
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28412-0008
Country	:	US
Telephone Number	:	917-589-5255
Fax Number	:

Provider Business Practice Location Address
First Line	:	1328 LAKE PARK BLVD N STE 106B
Second Line	:
City	:	CAROLINA BEACH
State	:	NC
Zip	:	28428-3906
Country	:	US
Telephone Number	:	910-782-7333
Fax Number	:

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

Provider Enumeration Date	:	10/06/2020
Last Update Date	:	10/06/2020

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Directions to “ OLGA O ORRACA L.AC” Practice Location

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