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NPI Code Detail

MEDICARE: ADRIENNE MICHELLE MULVILLE L.AC., M.OM

MEDICARE: ADRIENNE MICHELLE MULVILLE L.AC., M.OM
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
1171100000XAcupuncturist000198OH

General Provider Information

NPI Number : 1730481037
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADRIENNE MICHELLE MULVILLE L.AC., M.OM
Provider Business Mailing Address
First Line : 559 S HAWKINS AVE
Second Line :
City : AKRON
State : OH
Zip : 44320-1229
Country : US
Telephone Number : 952-240-1138
Fax Number :
Provider Business Practice Location Address
First Line : 3310 WARREN RD
Second Line :
City : CLEVELAND
State : OH
Zip : 44111-2031
Country : US
Telephone Number : 216-476-1700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2010
Last Update Date : 11/19/2010

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