Cicely Andree Conway, LAC

Individual provider Active NPI Acupuncturist · White River Junction, VT

NPI 1427367010 · NPPES record last updated May 9, 2018

Key facts

NPI
1427367010
Entity type
Individual (NPI type 1)
Primary specialty
Acupuncturist 171100000X
License
091.0134002 (VT)
Practice address
18 N Main St
White River Junction, VT 05001-7062
Phone
(206) 412-0777
NPI assigned
Sep 29, 2010
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
091.0134002VTMDAcupuncturist
MA60130160WAMDMechanotherapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mechanotherapist 172M00000X MA60130160 WA
Acupuncturist 171100000X 091.0134002 VT Yes

Addresses

Primary practice location

18 N Main St
White River Junction, VT 05001-7062

Mailing address

18 N Main St
White River Junction, VT 05001-7062
Phone (206) 412-0777

Other practice location 1

6215 sycamore ave nw
seattle, WA 98107
Phone (925) 297-9519

Other providers in White River Junction, VT

All providers in White River Junction, VT · Acupuncturist in Vermont

Sources for this page

Verify at the official NPI Registry.