# JADE LOTUS ACUPUNCTURE AND ORIENTAL MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** jade lotus Inc.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457964280
- **Authorized official:** JARED PATRICK GLENN AP, LMT (ACUPUNCTURE PHYSICIAN)
- **Authorized official phone:** (850) 368-7872

## Contact information

- **Practice address:** 12273 US HIGHWAY 98 W STE 120, MIRAMAR BEACH, FL 32550-6945
- **Practice address phone:** (850) 368-1685
- **Mailing address:** 1541 SCENIC GULF DR UNIT 5, MIRAMAR BEACH, FL 32550-6953
- **Mailing address phone:** (850) 368-1685

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | — | — | Yes |

## Other

- **Enumeration date:** 08/31/2020
- **Last updated:** 08/31/2020