Provider Demographics
NPI:1942479266
Name:KIRCHOFF, KAREN M (LIC AC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:KIRCHOFF
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1569 CENTRE ST
Mailing Address - Street 2:#2
Mailing Address - City:ROSLINDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02131-1905
Mailing Address - Country:US
Mailing Address - Phone:617-522-3990
Mailing Address - Fax:
Practice Address - Street 1:16 COHASSET ST
Practice Address - Street 2:
Practice Address - City:ROSLINDALE
Practice Address - State:MA
Practice Address - Zip Code:02131-3013
Practice Address - Country:US
Practice Address - Phone:617-522-3990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA532171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist