Individual
JESSICA PUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC.
Contact information
Practice address
1314 PEABODY AVE, MEMPHIS, TN 38104-3500
(901) 321-5803
Mailing address
220 HILLDALE LN, MILLINGTON, TN 38053-0368
(901) 641-6830
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
ACU0000000145
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ACU0000000145
TENNESSEE MEDICAL BOARD LICENSE
TN
Enumeration date
02/25/2019
Last updated
02/25/2019
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