Healthcare Provider Details

I. General information

NPI: 1568506525
Provider Name (Legal Business Name): JOANIE STEWART L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 08/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6617 10TH ST UNIT A1
ALEXANDRIA VA
22307-6617
US

IV. Provider business mailing address

6617 10TH ST UNIT A1
ALEXANDRIA VA
22307-6617
US

V. Phone/Fax

Practice location:
  • Phone: 941-685-3400
  • Fax:
Mailing address:
  • Phone: 941-685-3400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP2356
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberTL130
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number000224
License Number StateGA
# 4
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number0121000580
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: