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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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