| |
312 Ohio Ave N, Live Oak, FL 32064-2457 | |
(386) 361-8462 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Acupuncturist |
Location | 312 Ohio Ave N, Live Oak, Florida |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1609323385 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
171100000X | Acupuncturist | AP 3345 (Florida) | Primary |
171100000X | Acupuncturist | ACU.0001948 (Colorado) | Secondary |
Mailing Address | Practice Location Address |
---|---|
835 167th Pl, Live Oak, FL 32060-8025 Ph: (281) 658-5459 | 312 Ohio Ave N, Live Oak, FL 32064-2457 Ph: (386) 361-8462 |
Gretchen Marie Thevenau, AP Acupuncturist Medicare: Not Enrolled in Medicare Practice Location: 116 Conner St Ne, Live Oak, FL 32064 Phone: 386-361-8462 |