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NPI Code Detail

MEDICARE: MELANIE THOMPSON-CLARKE M.AC., LIC.AC.

MEDICARE:   MELANIE  THOMPSON-CLARKE  M.AC., 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
1171100000XAcupuncturistAC225ME

General Provider Information

NPI Number : 1851423636
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELANIE THOMPSON-CLARKE M.AC., LIC.AC.
Provider Business Mailing Address
First Line : 14 WINSTON ROAD
Second Line :
City : EAST BALDWIN
State : ME
Zip : 04024
Country : US
Telephone Number : 207-839-5529
Fax Number :
Provider Business Practice Location Address
First Line : 510 MAIN ST
Second Line :
City : GORHAM
State : ME
Zip : 04038-1339
Country : US
Telephone Number : 207-839-5529
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2007
Last Update Date : 07/08/2007

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Directions to “ MELANIE THOMPSON-CLARKE M.AC., LIC.AC.” Practice Location

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