Provider Demographics
NPI:1043682438
Name:ACUPUNCTURE & COMPLEMENTARY FAMILY CARE
Entity type:Organization
Organization Name:ACUPUNCTURE & COMPLEMENTARY FAMILY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:LICAC, APRN
Authorized Official - Phone:6039-780-3783
Mailing Address - Street 1:359 MAIN ST STE 3
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NH
Mailing Address - Zip Code:03835-3790
Mailing Address - Country:US
Mailing Address - Phone:603-978-0373
Mailing Address - Fax:
Practice Address - Street 1:359 MAIN ST STE 3
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NH
Practice Address - Zip Code:03835-3790
Practice Address - Country:US
Practice Address - Phone:603-978-0373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-24
Last Update Date:2015-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHACP 189171100000X
NH03622023261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty