Individual
JACQUELINE MEMMINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOT
Contact information
Practice address
250 NW 76TH DR, GAINESVILLE, FL 32607-6668
(352) 505-6363
(352) 505-6383
Mailing address
5638 SWAMP FOX RD, JACKSONVILLE, FL 32210-7312
(904) 294-3990
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MOT14504
FL
Other
Enumeration date
02/09/2011
Last updated
02/09/2011
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