MEDICARE: GREG ENOS ACUPUNCTURE LLC

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	AC00601	OR

General Provider Information

NPI Number	:	1740450493
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREG ENOS ACUPUNCTURE LLC

Provider Business Mailing Address
First Line	:	4220 SHASTA WAY
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97603-4842
Country	:	US
Telephone Number	:	541-884-1952
Fax Number	:

Provider Business Practice Location Address
First Line	:	2650 WASHBURN WAY UNIT 180
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97603-4591
Country	:	US
Telephone Number	:	541-884-1952
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BARBARA ENOS
Credential	:	RN, PMHMP
Telephone Number	:	541-884-1952

Provider Enumeration Date	:	03/10/2008
Last Update Date	:	03/25/2016

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Directions to “GREG ENOS ACUPUNCTURE LLC ” Practice Location

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