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General NPI Number Information
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NPI Number | 1114223955
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Entity Type | Organization
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Legal Business Name | A WAY OF LIFE ACUPUNCTURE, PLLC
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Dates
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Enumeration Date | 01/26/2011
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 4337 PABLO OAKS COURT BUILDING 200
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City | JACKSONVILLE
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State | FL
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Zip | 32224
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Country | US
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Telephone | 904-373-8415
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Fax |
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Provider Business Mailing Address
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Address Line | 4337 PABLO OAKS COURT BUILDING 200
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City | JACKSONVILLE
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State | FL
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Zip | 32224
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Country | US
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Telephone | 904-373-8415
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Fax |
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Authorized Official
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Title or Position | OWNER/ACUPUNCTURIST
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Name | CHRISTINE YASTRZEMSKI
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Credential | AP
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Telephone | 904-373-8415
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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 | FL2255
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License Number State | FL
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