Provider Demographics
NPI:1477918837
Name:KIRGAN, AUTUM (LAC)
Entity Type:Individual
Prefix:MS
First Name:AUTUM
Middle Name:
Last Name:KIRGAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 MILLER ST
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4264
Mailing Address - Country:US
Mailing Address - Phone:828-785-2670
Mailing Address - Fax:
Practice Address - Street 1:222 N LAFAYETTE ST STE 24
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28150-4450
Practice Address - Country:US
Practice Address - Phone:980-404-9477
Practice Address - Fax:704-495-6681
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-29
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171100000X
NC836171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty