Provider Demographics
NPI:1124279641
Name:SMUCKER, ANNE M (LAC)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:M
Last Name:SMUCKER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:203 SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-3625
Mailing Address - Country:US
Mailing Address - Phone:434-825-4181
Mailing Address - Fax:
Practice Address - Street 1:1982 ARLINGTON BLVD
Practice Address - Street 2:SUITE 5
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-1565
Practice Address - Country:US
Practice Address - Phone:434-825-4181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-02
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000161171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist