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General NPI Number Information
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NPI Number | 1104227768
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Entity Type | Organization
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Legal Business Name | CHAR DUMAIS AP, DOM INC
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Dates
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Enumeration Date | 09/12/2014
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Last Update Date | 09/12/2014
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Provider Practice Location Address
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Address Line | 13180 N CLEVELAND AVE SUITE 105
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City | NORTH FORT MYERS
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State | FL
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Zip | 33903-6200
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Country | US
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Telephone | 239-425-5477
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Fax |
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Provider Business Mailing Address
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Address Line | 17490 SABAL PALM DR
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City | NORTH FORT MYERS
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State | FL
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Zip | 33917-2231
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Country | US
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Telephone | 239-425-5477
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/ OWNER
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Name | MRS. CHARLOTTE MINEAR DUMAIS
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Credential | AP
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Telephone | 239-425-5477
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP1562
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License Number State | FL
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