JODY FORMAN, MSW, L.AC., PLLC (CHARLOTTESVILLE HEALING ARTS) - NPI NUMBER 1316243314
Provider Name: JODY FORMAN, MSW, L.AC., PLLC (CHARLOTTESVILLE HEALING ARTS)
NPI Number: 1316243314
Clasification: Acupuncturist (171100000X)
355 WEST RIO RD
Phone Number: (434) 975-0025
JODY FORMAN, MSW, L.AC., PLLC is an acupuncturist in Charlottesville, VA. The provider is an acupuncturist is a person who performs ancient therapy for alleviation of pain, anesthesia and treatment of some diseases. Acupuncturists use long, fine needles inserted into specific points in order to treat painful conditions or produce anesthesia. The assigned NPI number for this provider is 1316243314 and is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Charlottesville Healing Arts.
The provider's business address is:
355 WEST RIO RD
Phone: (434) 975-0025
The provider's authorized official is Jody Forman .
The authorized official title is Licensed Acupuncturist and has the following contact phone number (434) 975-0025.
The enumeration date for this NPI number is 2/8/2011 and was last updated on 2/8/2011.
Map - Location of Practice
||MS. ANNE M SMUCKER, L.AC.
||MR. MICHAEL G JABALEE, LIC. AC., M. AC.
||MRS. CALI BELKNAP GASTON, RN, LAC
||MRS. SALLIE BOSTICK SMITHWICK, RN, M.AC., L.AC.
||JENNIFER D MAKIHARA, LIC. AC.
||ROBERT V. CLICKNER, L.AC.
||MRS. MILA ZIMMERMAN, M.AC., L.AC. DIPL.AC
The following information regarding the scope of practice of this provider is available:
||Entity Type Code
||Employer Identification Number EIN
||Provider Organization Name Legal Business Name
||JODY FORMAN, MSW, L.AC., PLLC
||Provider Other Organization Name
||CHARLOTTESVILLE HEALING ARTS
||Provider Other Organization Name Type Code
||Provider First Line Business Practice Location Address
||355 WEST RIO RD
||Provider Second Line Business Practice Location Address
||Provider Business Practice Location Address City Name
||Provider Business Practice Location Address State Name
||Provider Business Practice Location Address Postal Code
||Provider Business Practice Location Address Country Code If outside U S
||Provider Business Practice Location Address Telephone Number
||Provider Enumeration Date
||Last Update Date
||Authorized Official Last Name
||Authorized Official First Name
||Authorized Official Title or Position
||Authorized Official Telephone Number
||Healthcare Provider Taxonomy Code 1
||Provider License Number 1
||Provider License Number State Code 1
||Healthcare Provider Primary Taxonomy Switch 1
||Is Organization Subpart
||Authorized Official Name Prefix Text
||Authorized Official Credential Text
||Healthcare Provider Taxonomy Group 1
||193400000X SINGLE SPECIALTY GROUP
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This page was last updated on: 11/14/2014
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