Provider Demographics
NPI:1700097920
Name:ACUPUNCTURE & QI GONG CENTER, P.A.
Entity Type:Organization
Organization Name:ACUPUNCTURE & QI GONG CENTER, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CAMILLE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KLINKER
Authorized Official - Suffix:
Authorized Official - Credentials:M AC
Authorized Official - Phone:410-721-4356
Mailing Address - Street 1:2355 DAVIDSONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:GAMBRILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21054-2105
Mailing Address - Country:US
Mailing Address - Phone:410-721-4356
Mailing Address - Fax:301-261-6944
Practice Address - Street 1:2355 DAVIDSONVILLE RD
Practice Address - Street 2:
Practice Address - City:GAMBRILLS
Practice Address - State:MD
Practice Address - Zip Code:21054-2105
Practice Address - Country:US
Practice Address - Phone:410-721-4356
Practice Address - Fax:301-261-6944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01068171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty