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NPI Code Detail

MEDICARE: NATHANIEL LEE NOVGROD L,AC.

MEDICARE: NATHANIEL LEE NOVGROD L,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
1171100000XAcupuncturist550NC

General Provider Information

NPI Number : 1952623605
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHANIEL LEE NOVGROD L,AC.
Provider Business Mailing Address
First Line : 292 N HAYWOOD ST
Second Line :
City : WAYNESVILLE
State : NC
Zip : 28786-3748
Country : US
Telephone Number : 828-283-0268
Fax Number :
Provider Business Practice Location Address
First Line : 292 N HAYWOOD ST
Second Line :
City : WAYNESVILLE
State : NC
Zip : 28786-3748
Country : US
Telephone Number : 828-283-0268
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2010
Last Update Date : 02/23/2010

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Directions to “ NATHANIEL LEE NOVGROD L,AC.” Practice Location

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