Jaclyn M Oddi, D.O.M.

Individual provider Active NPI Acupuncturist · Cedar Crest, NM

NPI 1447430285 · NPPES record last updated Nov 9, 2007

Key facts

NPI
1447430285
Entity type
Individual (NPI type 1)
Primary specialty
Acupuncturist 171100000X
License
825 (NM)
Practice address
12131 Hwy 14 N
Cedar Crest, NM 87008-9461
Phone
(505) 269-2599
NPI assigned
Nov 9, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
825NMMDAcupuncturist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 825 NM Yes

Addresses

Primary practice location

12131 Hwy 14 N
Cedar Crest, NM 87008-9461

Mailing address

12131 Hwy 14 N
Cedar Crest, NM 87008-9461
Phone (505) 269-2599

Other identifiers

IdentifierTypeStateIssuer
NM00RH55OtherNMBCBS

Other providers in Cedar Crest, NM

All providers in Cedar Crest, NM · Acupuncturist in New Mexico

Sources for this page

Verify at the official NPI Registry.