Organization
ELEMENTAL SOURCE ACUPUNCTURE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KALLIE GUIMOND M.OM (OWNER/LICENSED ACUPUNCTURIST)
(240) 432-7522
Entity
Organization
Contact information
Practice address
263 W PATRICK ST, SUITE 2, FREDERICK, MD 21701-6910
(240) 432-7522
Mailing address
3627 LEW WALLACE ST, FREDERICK, MD 21704-7872
(240) 432-7522
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
MD
Other
Enumeration date
11/18/2016
Last updated
11/18/2016
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