Provider Demographics
NPI:1770651507
Name:TRUSZ, NANCY G (LIC AC)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:G
Last Name:TRUSZ
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ACUPUNCTURE SERV OF RANDOLPH
Mailing Address - Street 2:24 SOUTH MAIN STREET
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368
Mailing Address - Country:US
Mailing Address - Phone:781-963-0457
Mailing Address - Fax:
Practice Address - Street 1:ACUPUNCTURE SERV OF RANDOLPH
Practice Address - Street 2:24 SOUTH MAIN STREET
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368
Practice Address - Country:US
Practice Address - Phone:781-963-0457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA201171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist