Individual
MRS. JENNIFER SUZANNE VILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC
Contact information
Practice address
625 AYRAULT RD, FAIRPORT, NY 14450-3076
(585) 465-1056
Mailing address
1507 PROVIDENCE DR, WEBSTER, NY 14580-9492
(315) 730-5175
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
005978
NY
Other
Enumeration date
05/17/2017
Last updated
05/07/2020
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