MEDICARE: BRITTANY MILACCI MS 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	65.000310	OH

General Provider Information

NPI Number	:	1730680737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY MILACCI MS L.AC.

Provider Business Mailing Address
First Line	:	1815 W 44TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44113-3205
Country	:	US
Telephone Number	:	503-915-9036
Fax Number	:

Provider Business Practice Location Address
First Line	:	14520 DETROIT AVE
Second Line	:
City	:	LAKEWOOD
State	:	OH
Zip	:	44107-4317
Country	:	US
Telephone Number	:	216-227-1490
Fax Number	:

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

Provider Enumeration Date	:	02/24/2018
Last Update Date	:	02/24/2018

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