Individual
GRETCHEN MARIE THEVENAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AP
Contact information
Practice address
116 CONNER ST NE, LIVE OAK, FL 32064-2470
(386) 361-8462
Mailing address
835 167TH PL, LIVE OAK, FL 32060-8025
(281) 658-5459
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
ACU.0001948
CO
171100000X
Acupuncturist
Primary
AP3345
FL
Other
Enumeration date
08/13/2016
Last updated
10/02/2018
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