Provider Demographics
NPI:1427125152
Name:MINGINS, GEORGE F (LIC AC)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:F
Last Name:MINGINS
Suffix:
Gender:M
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 LOWELL ST
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-6630
Mailing Address - Country:US
Mailing Address - Phone:978-688-5733
Mailing Address - Fax:
Practice Address - Street 1:204 LOWELL ST
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-6630
Practice Address - Country:US
Practice Address - Phone:978-688-5733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA305171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist