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General NPI Number Information
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NPI Number | 1396269981
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Entity Type | Individual
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Provider Name | WENDY LEIGH PALLONE GOLFO DOM, AP
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Gender | Female
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Dates
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Enumeration Date | 07/26/2017
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Last Update Date | 07/26/2017
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Provider Practice Location Address
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Address Line | 214 MOODY BLVD
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City | FLAGLER BEACH
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State | FL
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Zip | 32136-3372
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Country | US
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Telephone | 386-439-2609
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Fax |
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Provider Business Mailing Address
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Address Line | 36 SEATTLE TRL
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City | PALM COAST
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State | FL
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Zip | 32164-5530
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Country | US
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Telephone | 386-237-8714
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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 | AP3715
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License Number State | FL
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