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General NPI Number Information
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NPI Number | 1285278986
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Entity Type | Organization
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Legal Business Name | ACU CHATT PLLC
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Dates
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Enumeration Date | 11/05/2019
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Last Update Date | 11/05/2019
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Provider Practice Location Address
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Address Line | 1405 COWART ST STE 115
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City | CHATTANOOGA
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State | TN
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Zip | 37408-1177
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Country | US
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Telephone | 423-708-5651
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Fax |
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Provider Business Mailing Address
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Address Line | 300 W MIDVALE AVE APT 7
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City | CHATTANOOGA
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State | TN
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Zip | 37405-4701
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Country | US
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Telephone | 727-543-6554
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JESSICA DWYER
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Credential | LAC
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Telephone | 423-708-5651
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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 |
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License Number State |
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