Provider Demographics
NPI:1376973545
Name:JEN MARKS ACUPUNCTURE AND HERBAL MEDICINE CENTER, LLC
Entity Type:Organization
Organization Name:JEN MARKS ACUPUNCTURE AND HERBAL MEDICINE CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:C
Authorized Official - Last Name:MARKS
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:386-299-9947
Mailing Address - Street 1:2431 HABERSHAM ST STE B
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31401-9360
Mailing Address - Country:US
Mailing Address - Phone:386-299-9947
Mailing Address - Fax:
Practice Address - Street 1:2431 HABERSHAM ST STE B
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31401-9360
Practice Address - Country:US
Practice Address - Phone:386-299-9947
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-25
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA323171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty