MEDICARE: WULF 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	AP2279	FL

General Provider Information

NPI Number	:	1477964955
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WULF ACUPUNCTURE LLC

Provider Business Mailing Address
First Line	:	6000A SAWGRASS VILLAGE CIR
Second Line	:	SUITE 10
City	:	PONTE VEDRA BEACH
State	:	FL
Zip	:	32082-5011
Country	:	US
Telephone Number	:	904-994-3709
Fax Number	:

Provider Business Practice Location Address
First Line	:	6000A SAWGRASS VILLAGE CIR
Second Line	:	SUITE 10
City	:	PONTE VEDRA BEACH
State	:	FL
Zip	:	32082-5011
Country	:	US
Telephone Number	:	904-994-3709
Fax Number	:

Authorized Official
Title or Position	:	AP
Name	:	MS. CONSTANCE WULF
Credential	:	AP
Telephone Number	:	904-994-3709

Provider Enumeration Date	:	05/18/2014
Last Update Date	:	06/08/2023

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