Individual
JANA SAMPLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC.
Contact information
Practice address
455 E PACES FERRY RD NE, SUITE 201, ATLANTA, GA 30305-3313
(404) 528-3500
Mailing address
2563 DRESDEN DR, ATLANTA, GA 30341-5220
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
350
GA
171100000X
Acupuncturist
AC 16064
CA
Other
Enumeration date
04/04/2012
Last updated
09/02/2014
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