Individual
THEA ELIJAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L. AC.
Contact information
Practice address
1037 WESTERN AVE, BRATTLEBORO, VT 05301-7133
(802) 257-8622
Mailing address
1037 WESTERN AVE, BRATTLEBORO, VT 05301-7133
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
091.0000188
VT
Other
Enumeration date
12/26/2022
Last updated
12/26/2022
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