MEDICARE: COLABELLA ACUPUNCTURE, INC.

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	UO1616	MD

General Provider Information

NPI Number	:	1871771584
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLABELLA ACUPUNCTURE, INC.

Provider Business Mailing Address
First Line	:	7016 WALLIS AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21215-1711
Country	:	US
Telephone Number	:	443-812-8451
Fax Number	:

Provider Business Practice Location Address
First Line	:	8 GREENSPRING VALLEY RD STE 100
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-4143
Country	:	US
Telephone Number	:	410-654-8997
Fax Number	:

Authorized Official
Title or Position	:	ACUPUNCTURIST
Name	:	MRS. MICHELLE ANDREA COLABELLA
Credential	:	L.AC
Telephone Number	:	443-812-8451

Provider Enumeration Date	:	02/05/2008
Last Update Date	:	02/05/2008

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