Individual
JEANNIE LASLO DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AP, DIPL OM, ERYT
Contact information
Practice address
316 DUNLAWTON AVE, PORT ORANGE, FL 32127-4456
(386) 872-5757
Mailing address
1645 DUNLAWTON AVE APT 1924, PORT ORANGE, FL 32127-7923
(541) 639-2618
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
4301
FL
Other
Enumeration date
08/29/2022
Last updated
08/29/2022
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