Individual
MR. JENNINGS E. MOONEYHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SA-C
Contact information
Practice address
1310 1ST ST S, JACKSONVILLE BEACH, FL 32250-6404
(904) 222-5491
(904) 627-1609
Mailing address
1310 1ST ST S, JACKSONVILLE BEACH, FL 32250-6404
(904) 222-5491
(904) 627-1609
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
94-122
TN
Other
Enumeration date
01/07/2014
Last updated
01/07/2014
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