# BLUEGREEN ACUPUNCTURE AND BODYWORK

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124335682
- **Authorized official:** MRS. LEONORA GEVAERD MANEKIN L.AC (ACUPUNCTURIST)
- **Authorized official phone:** (443) 388-1110

## Contact information

- **Practice address:** 1515 LABELLE AVE, BALTIMORE, MD 21204-6606
- **Practice address phone:** (443) 388-1110
- **Mailing address:** 1515 LABELLE AVE, BALTIMORE, MD 21204-6606
- **Mailing address phone:** (443) 388-1110

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | — | — | Yes |

## Other

- **Enumeration date:** 09/06/2010
- **Last updated:** 09/06/2010