Provider Demographics
NPI:1962767194
Name:CRISTI DEMARCO ACUPUNCTURE
Entity type:Organization
Organization Name:CRISTI DEMARCO ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CRISTI
Authorized Official - Middle Name:CANALI
Authorized Official - Last Name:DEMARCO
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:207-778-9700
Mailing Address - Street 1:193 FRONT ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:FARMINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04938-5834
Mailing Address - Country:US
Mailing Address - Phone:207-778-9700
Mailing Address - Fax:
Practice Address - Street 1:193 FRONT ST
Practice Address - Street 2:SUITE 2
Practice Address - City:FARMINGTON
Practice Address - State:ME
Practice Address - Zip Code:04938-5834
Practice Address - Country:US
Practice Address - Phone:207-778-9700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-13
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAC321171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty