Individual
JACLYN M ODDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.M.
Contact information
Practice address
12131 HWY 14 N, CEDAR CREST, NM 87008-9461
(505) 269-2599
Mailing address
12131 HWY 14 N, CEDAR CREST, NM 87008-9461
(505) 269-2599
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
825
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NM00RH55
BCBS
NM
Enumeration date
11/09/2007
Last updated
11/09/2007
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