Individual
MISS AUDREY LEE JERNIGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
212 SAN MARCO AVE, ST AUGUSTINE, FL 32084-2773
(904) 392-5399
(904) 819-5851
Mailing address
54 MACARIS ST, ST AUGUSTINE, FL 32084-2164
(904) 392-5399
(904) 819-5851
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
35509
FL
Other
Enumeration date
04/18/2007
Last updated
07/08/2007
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