Provider Demographics
NPI:1235614090
Name:THE VILLAGE ACUPUNCTURIST
Entity type:Organization
Organization Name:THE VILLAGE ACUPUNCTURIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGETTIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:LIC AC
Authorized Official - Phone:508-238-2077
Mailing Address - Street 1:50 OLIVER ST STE 114
Mailing Address - Street 2:
Mailing Address - City:NORTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02356-1477
Mailing Address - Country:US
Mailing Address - Phone:508-472-6426
Mailing Address - Fax:508-238-5077
Practice Address - Street 1:50 OLIVER ST STE 114
Practice Address - Street 2:
Practice Address - City:NORTH EASTON
Practice Address - State:MA
Practice Address - Zip Code:02356-1477
Practice Address - Country:US
Practice Address - Phone:508-472-6426
Practice Address - Fax:508-238-5077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA230148OtherACUPUNCTURE LICENSE