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General NPI Number Information
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NPI Number | 1386884559
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Entity Type | Individual
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Provider Name | DORI C. BOZUNG A.P.
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Gender | Female
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Dates
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Enumeration Date | 03/02/2009
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Last Update Date | 03/02/2009
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Provider Practice Location Address
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Address Line | 88 RIBERIA ST. SUITE 110
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City | ST. AUGUSTINE
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State | FL
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Zip | 32085
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Country | US
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Telephone | 904-687-5352
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Fax |
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Provider Business Mailing Address
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Address Line | 35 SHENANDOAH ST.
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City | ST. AUGUSTINE
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State | FL
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Zip | 32084
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Country | US
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Telephone | 904-687-5352
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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 | AP2251
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License Number State | FL
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