MEDICARE: CHRISTIE-JO STARVISH L.AC., DAOM

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	DAOM00090	RI

General Provider Information

NPI Number	:	1952015364
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIE-JO STARVISH L.AC., DAOM

Provider Business Mailing Address
First Line	:	446 BROADWAY
Second Line	:
City	:	NEWPORT
State	:	RI
Zip	:	02840-1732
Country	:	US
Telephone Number	:	813-325-9398
Fax Number	:

Provider Business Practice Location Address
First Line	:	446 BROADWAY
Second Line	:
City	:	NEWPORT
State	:	RI
Zip	:	02840-1732
Country	:	US
Telephone Number	:	813-325-9398
Fax Number	:

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

Provider Enumeration Date	:	01/10/2023
Last Update Date	:	01/10/2023

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