Provider Demographics
NPI:1326458316
Name:MARESCA-JAY, MARY G (LICENSED ACUPUNCTURI)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:G
Last Name:MARESCA-JAY
Suffix:
Gender:F
Credentials:LICENSED ACUPUNCTURI
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:GRACE
Other - Last Name:MARESCA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LICENSED ACUPUNCTURI
Mailing Address - Street 1:718 WELLS AVENUE, #2
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917
Mailing Address - Country:US
Mailing Address - Phone:203-848-0876
Mailing Address - Fax:
Practice Address - Street 1:718 WELLS AVENUE, #2
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917
Practice Address - Country:US
Practice Address - Phone:203-848-0876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-30
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist