MEDICARE: RED SAGE ACUPUNCTURE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	AP3093	FL

General Provider Information

NPI Number	:	1316482805
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RED SAGE ACUPUNCTURE LLC

Provider Business Mailing Address
First Line	:	4741 ATLANTIC BLVD STE E2
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-1138
Country	:	US
Telephone Number	:	904-572-7929
Fax Number	:

Provider Business Practice Location Address
First Line	:	4741 ATLANTIC BLVD STE E2
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-1138
Country	:	US
Telephone Number	:	904-572-7929
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	JANN WHIDDEN TURPIN
Credential	:
Telephone Number	:	904-572-7929

Provider Enumeration Date	:	12/20/2016
Last Update Date	:	12/30/2016

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Directions to “RED SAGE ACUPUNCTURE LLC ” Practice Location

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