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General NPI Number Information
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NPI Number | 1881908267
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Entity Type | Organization
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Legal Business Name | JACKSONVILLLE ACUPUNCTURE CLINIC, PA
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Dates
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Enumeration Date | 07/28/2010
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Last Update Date | 09/08/2010
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Provider Practice Location Address
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Address Line | 13241 BARTRAM PARK BLVD UNIT 1017
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City | JACKSONVILLE
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State | FL
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Zip | 32258-5234
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Country | US
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Telephone | 904-260-2598
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Fax |
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Provider Business Mailing Address
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Address Line | 13241 BARTRAM PARK BLVD UNIT 1017
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City | JACKSONVILLE
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State | FL
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Zip | 32258-5234
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. JAMIE CATLETT
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Credential | AP
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Telephone | 904-260-2598
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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 | AP2512
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License Number State | FL
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