Individual
DR. JESSICA CARLEEN FUNICELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
306 ENTERPRISE DR STE B, FOREST, VA 24551-2644
(434) 385-6333
Mailing address
320 RIVERSIDE DR, LYNCHBURG, VA 24503-1319
(434) 326-5761
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104556526
VA
111N00000X
Chiropractor
7487
AZ
Other
Enumeration date
02/09/2007
Last updated
08/09/2007
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