Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH7238 | FL |
NPI | 1003238015 |
---|---|
Provider Name | Jeneane Wakula |
First Address | Hobe Sound, FL 33455-3265 |
Second Address | Hobe Sound, FL 33455-5312 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2014 |
Last Update Date | 09/01/2014 |