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Organization
LM AT BLUEGREEN
Active
Organization
LM AT BLUEGREEN
Active
Other names
BlueGreen Acupuncture
Organization subpart
No
Provider details
NPI number
Authorized official
LEONORA GEVAERD MANEKIN LAC, MAC (BUSINESS OWNER)
(443) 388-1110
Entity
Organization
Contact information
Practice address
301 W 29TH ST, SUITE 2001, BALTIMORE, MD 21211-2910
(443) 388-1110
Mailing address
301 W 29TH ST, SUITE 2001, BALTIMORE, MD 21211-2910
(443) 388-1110
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
U01822
MD
Other
Enumeration date
09/03/2013
Last updated
12/28/2016
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