Provider Demographics
NPI:1588891691
Name:ACTUAL SYNERGY CONSULTING
Entity type:Organization
Organization Name:ACTUAL SYNERGY CONSULTING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MITZI
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-344-0720
Mailing Address - Street 1:294 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-2571
Mailing Address - Country:US
Mailing Address - Phone:781-344-0720
Mailing Address - Fax:781-344-0891
Practice Address - Street 1:294 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-2571
Practice Address - Country:US
Practice Address - Phone:781-344-0720
Practice Address - Fax:781-344-0891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-16
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty