Provider Demographics
NPI:1184259905
Name:WHITNEY BOLAND ACUPUNCTURE
Entity type:Organization
Organization Name:WHITNEY BOLAND ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:WHITNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLAND
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:423-838-5163
Mailing Address - Street 1:164 HOME AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-5046
Mailing Address - Country:US
Mailing Address - Phone:423-838-5163
Mailing Address - Fax:
Practice Address - Street 1:996 S MAIN ST STE 1B
Practice Address - Street 2:
Practice Address - City:STOWE
Practice Address - State:VT
Practice Address - Zip Code:05672-5195
Practice Address - Country:US
Practice Address - Phone:423-838-5163
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-12
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty