Provider Demographics
NPI:1760130025
Name:REDFERN ACUPUNCTURE AND HERBS
Entity Type:Organization
Organization Name:REDFERN ACUPUNCTURE AND HERBS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:REDFERN
Authorized Official - Suffix:
Authorized Official - Credentials:LIC AC
Authorized Official - Phone:781-519-6823
Mailing Address - Street 1:53 PLAIN ST # 7
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-7049
Mailing Address - Country:US
Mailing Address - Phone:781-519-6823
Mailing Address - Fax:
Practice Address - Street 1:53 PLAIN ST # 7
Practice Address - Street 2:
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-7049
Practice Address - Country:US
Practice Address - Phone:781-519-6823
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty