Provider Demographics
NPI:1568751899
Name:FIVE POINTS ACUPUNCTURE & WELLNESS LLC
Entity Type:Organization
Organization Name:FIVE POINTS ACUPUNCTURE & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:D
Authorized Official - Last Name:WHALEN
Authorized Official - Suffix:
Authorized Official - Credentials:LIC AC
Authorized Official - Phone:781-626-1078
Mailing Address - Street 1:66 ELMWOOD ST
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02144-2440
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20 PONDMEADOW DR
Practice Address - Street 2:SUITE 107
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867-3218
Practice Address - Country:US
Practice Address - Phone:781-626-1078
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA226329171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty