MEDICARE: CENTER POINT ACUPUNCTURE MEDICINE, 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	261QH0100X	Health Service Clinic/Center	66.000022	OH

General Provider Information

NPI Number	:	1841709474
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTER POINT ACUPUNCTURE MEDICINE, LLC

Provider Business Mailing Address
First Line	:	3736 EASTON LOOP W
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-6148
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1496 OLD HENDERSON RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-3614
Country	:	US
Telephone Number	:	614-595-6412
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	STACEY ANNE KENT
Credential	:	L.OM
Telephone Number	:	614-595-6412

Provider Enumeration Date	:	09/27/2017
Last Update Date	:	03/17/2018

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