MEDICARE: MICHELE PAULA ROY LIC.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	207382	MA

General Provider Information

NPI Number	:	1750568069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELE PAULA ROY LIC.AC.

Provider Business Mailing Address
First Line	:	82 PARK AVE
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01609-1742
Country	:	US
Telephone Number	:	508-363-3490
Fax Number	:	508-798-3418

Provider Business Practice Location Address
First Line	:	82 PARK AVE
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01609-1742
Country	:	US
Telephone Number	:	508-363-3490
Fax Number	:	508-798-3418

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

Provider Enumeration Date	:	01/29/2008
Last Update Date	:	01/29/2008

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Directions to “ MICHELE PAULA ROY LIC.AC.” Practice Location

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