Provider Demographics
NPI:1033423884
Name:DC ACUPUNCTURE
Entity Type:Organization
Organization Name:DC ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:BRONWYN
Authorized Official - Middle Name:DALTON
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:MAC, LAC, DIPLAC
Authorized Official - Phone:202-321-2923
Mailing Address - Street 1:1932 35TH PL NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-2201
Mailing Address - Country:US
Mailing Address - Phone:202-321-2923
Mailing Address - Fax:
Practice Address - Street 1:1740 WISCONSIN AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-2313
Practice Address - Country:US
Practice Address - Phone:202-321-2923
Practice Address - Fax:202-333-7667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-04
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCAC500090305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service