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General NPI Number Information
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NPI Number | 1942967906
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Entity Type | Organization
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Legal Business Name | ASCENDING MOON ACUPUNCTURE, LLC
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Dates
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Enumeration Date | 11/24/2021
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Last Update Date | 11/24/2021
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Provider Practice Location Address
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Address Line | 14215 SPARTINA CT STE 300
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City | JACKSONVILLE
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State | FL
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Zip | 32224-3232
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Country | US
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Telephone | 858-603-1955
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Fax |
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Provider Business Mailing Address
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Address Line | 341 HICKORY HOLLOW DR N
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City | JACKSONVILLE
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State | FL
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Zip | 32225-3057
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Country | US
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Telephone | 858-603-1955
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURE PHYSICIAN
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Name | MS. JENNIFER A MCKEEVER
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Credential | AP
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Telephone | 858-603-1955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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