Individual
MR. PICKENS ALLISON GANTT III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
1505 N FEDERAL HWY, LAKE WORTH, FL 33460
(561) 533-7475
Mailing address
1505 N FEDERAL HWY, LAKE WORTH, FL 33460
(561) 533-7475
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AP4003
FL
Other
Enumeration date
12/26/2018
Last updated
12/26/2018
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