Provider Demographics
NPI:1497968358
Name:MEATTEY, ALICE GANSECKI (LIC AC LICENSED ACUP)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:GANSECKI
Last Name:MEATTEY
Suffix:
Gender:F
Credentials:LIC AC LICENSED ACUP
Other - Prefix:
Other - First Name:ALICE
Other - Middle Name:C
Other - Last Name:GANSECKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:109 SPUR ROAD
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-9110
Mailing Address - Country:US
Mailing Address - Phone:603-742-3940
Mailing Address - Fax:
Practice Address - Street 1:74 STATE ROAD
Practice Address - Street 2:SUITE NUMBER 201
Practice Address - City:KITTERY
Practice Address - State:ME
Practice Address - Zip Code:03904
Practice Address - Country:US
Practice Address - Phone:207-439-5809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAC120171100000X
NHACP001171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist