Individual
ALEXA BULLERDIECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LIC.AC.
Contact information
Practice address
32 BOW ST, #3, SOMERVILLE, MA 02143-2934
(617) 909-4411
Mailing address
32 BOW ST, #3, SOMERVILLE, MA 02143-2934
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
222846
MA
Other
Enumeration date
09/11/2012
Last updated
09/11/2012
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