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Individual

MRS. DAWN LAVELLE SHARE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
A.P.

Contact information

Practice address
1400 HAND AVE STE N, ORMOND BEACH, FL 32174-8196
(386) 290-9493
Mailing address
145 HERITAGE CIR, ORMOND BEACH, FL 32174-4208
(386) 290-9493

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AP2726
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
27-0959639
IRS
FL
01
27-5007598
IRS
FL
Enumeration date
09/21/2009
Last updated
09/10/2012
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