Provider Demographics
NPI:1265635304
Name:WOZNYSMITH, ERIC DASIE (L AC)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:DASIE
Last Name:WOZNYSMITH
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 BIGGS PURCHASE LN
Mailing Address - Street 2:
Mailing Address - City:LOTHIAN
Mailing Address - State:MD
Mailing Address - Zip Code:20711-2300
Mailing Address - Country:US
Mailing Address - Phone:410-956-0299
Mailing Address - Fax:
Practice Address - Street 1:230 BIGGS PURCHASE LN
Practice Address - Street 2:
Practice Address - City:LOTHIAN
Practice Address - State:MD
Practice Address - Zip Code:20711-2300
Practice Address - Country:US
Practice Address - Phone:410-956-0299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU-01268171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist