Provider Demographics
NPI:1255455440
Name:WIRTH, JOYCE FIRSCHING (LAC, DIPL AC)
Entity type:Individual
Prefix:
First Name:JOYCE
Middle Name:FIRSCHING
Last Name:WIRTH
Suffix:
Gender:F
Credentials:LAC, DIPL AC
Other - Prefix:
Other - First Name:JOYCE
Other - Middle Name:MARIE
Other - Last Name:FIRSCHING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC, DIPL AC
Mailing Address - Street 1:PO BOX 47
Mailing Address - Street 2:
Mailing Address - City:OCCOQUAN
Mailing Address - State:VA
Mailing Address - Zip Code:22125-0047
Mailing Address - Country:US
Mailing Address - Phone:703-328-5215
Mailing Address - Fax:
Practice Address - Street 1:103 WEST LOCUST STREET
Practice Address - Street 2:
Practice Address - City:OCCOQUAN
Practice Address - State:VA
Practice Address - Zip Code:22125-0047
Practice Address - Country:US
Practice Address - Phone:703-328-5215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000343171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist