MEDICARE: JLW,INC

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	0121000281	VA

General Provider Information

NPI Number	:	1932119757
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JLW,INC

Provider Business Mailing Address
First Line	:	837 FIRST COLONIAL RD
Second Line	:	SUITE A
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-6195
Country	:	US
Telephone Number	:	757-428-4286
Fax Number	:	757-428-4286

Provider Business Practice Location Address
First Line	:	837 FIRST COLONIAL RD
Second Line	:	SUITE A
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-6195
Country	:	US
Telephone Number	:	757-428-4286
Fax Number	:	757-428-4286

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. JENNIFER WARREN SADLER
Credential	:	L.AC, M.AC, DIPL.AC
Telephone Number	:	757-428-4286

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	06/26/2008

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