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Individual

JODY SOUTHALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.AC., L.AC.

Contact information

Practice address
5570 STERRETT PL, SUITE 308, COLUMBIA, MD 21044-2641
(443) 745-6799
Mailing address
10333 CONGRESSIONAL CT, ELLICOTT CITY, MD 21042-2124

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
U02317
MD

Other

Enumeration date
05/23/2016
Last updated
05/23/2016
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