Individual
MRS. VIVIAN MANDUCA-MARQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.P., D.O.M.
Contact information
Practice address
215 WESTERN BLVD STE 300, JACKSONVILLE, NC 28546-5732
(910) 989-0002
(910) 353-9753
Mailing address
99 VILLAGE DR, SUITE 16, JACKSONVILLE, NC 28546-7067
(910) 989-0002
(910) 353-9753
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
379
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C-0585
BLUE CROSS BLUE SHIELD FL
FL
Enumeration date
04/26/2006
Last updated
01/12/2011
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