Provider Demographics
NPI:1497298129
Name:GOOD HEARTH: EASTERN MEDICAL ARTS
Entity Type:Organization
Organization Name:GOOD HEARTH: EASTERN MEDICAL ARTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, ACUPUNCTURIST, HERBALIST
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:TOBEY
Authorized Official - Last Name:WILLIAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:207-332-9941
Mailing Address - Street 1:75 MECHANIC ST
Mailing Address - Street 2:SHARP'S POINT SOUTH, SUITE 202W
Mailing Address - City:ROCKLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04841-3513
Mailing Address - Country:US
Mailing Address - Phone:207-332-9941
Mailing Address - Fax:
Practice Address - Street 1:75 MECHANIC ST
Practice Address - Street 2:SHARP'S POINT SOUTH, SUITE 202W
Practice Address - City:ROCKLAND
Practice Address - State:ME
Practice Address - Zip Code:04841-3513
Practice Address - Country:US
Practice Address - Phone:207-332-9941
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-29
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAC551171100000X
HI1168171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty