MEDICARE: MALGORZATA BOOTH 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
1	171100000X	Acupuncturist	0121000836	VA

General Provider Information

NPI Number	:	1982145058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MALGORZATA BOOTH L.AC.

Provider Business Mailing Address
First Line	:	18841 ACCOKEEK TER
Second Line	:
City	:	LEESBURG
State	:	VA
Zip	:	20176-8453
Country	:	US
Telephone Number	:	703-300-0797
Fax Number	:

Provider Business Practice Location Address
First Line	:	520 N WASHINGTON ST STE 100
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22046-3538
Country	:	US
Telephone Number	:	703-300-0797
Fax Number	:

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

Provider Enumeration Date	:	03/09/2017
Last Update Date	:	03/09/2017

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Directions to “ MALGORZATA BOOTH L.AC.” Practice Location

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