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General NPI Number Information
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NPI Number | 1235602855
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Entity Type | Individual
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Provider Name | JILL MARIE SCHIMMELPFENNIG LAC, MSOM
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Gender | Female
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Dates
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Enumeration Date | 01/07/2019
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Last Update Date | 01/07/2019
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Provider Practice Location Address
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Address Line | 357 S LANDMARK AVE STE B
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City | BLOOMINGTON
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State | IN
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Zip | 47403-5002
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Country | US
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Telephone | 812-334-5815
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Fax | 812-339-8352
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Provider Business Mailing Address
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Address Line | 1004 S DUNN ST
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City | BLOOMINGTON
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State | IN
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Zip | 47401-5928
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Country | US
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Telephone | 812-320-3032
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 84000146A
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License Number State | IN
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