National Provider Identifier
Jennifer Suzanne Villa, L.AC
Jennifer Suzanne Villa, L.AC is listed in the NPPES registry with a primary specialty of Acupuncturist in Fairport, NY and a listed phone number of (585) 465-1056.
Profile Overview
- NPI
- 1639606981
- Provider Type
- Individual
- Primary Specialty
- Acupuncturist
- Enumeration Date
- May 17, 2017
- Last Updated
- May 07, 2020
Practice Location
- 625 Ayrault RD
- Fairport, NY 14450-3076
Phone: (585) 465-1056
Mailing Address
- 1507 Providence Dr
- Webster, NY 14580-9492
Specialties
- Acupuncturist (171100000X)
Full Record
- NPI
- 1639606981
- Entity Type
- Individual
- Last Name
- Villa
- First Name
- Jennifer
- Middle Name
- Suzanne
- Name Prefix
- Mrs.
- Credential
- L.AC
- Provider Other Last Name
- Long
- Provider Other First Name
- Jennifer
- Provider Other Middle Name
- Suzanne
- Provider Other Credential Text
- L.AC
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 1507 Providence Dr
- Mailing City
- Webster
- Mailing State
- NY
- Mailing ZIP Code
- 14580-9492
- Mailing Country
- US
- Mailing Phone
- (315) 730-5175
- Practice Street Address
- 625 Ayrault RD
- Practice City
- Fairport
- Practice State
- NY
- Practice ZIP Code
- 14450-3076
- Practice Country
- US
- Practice Phone
- (585) 465-1056
- Enumeration Date
- May 17, 2017
- Last Updated
- May 07, 2020
- Sex
- Female
- Sole Proprietor
- Yes
- Certification Date
- May 07, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Acupuncturist (171100000X)