Provider Demographics
NPI:1689836363
Name:SOMMERVILLE, JEWEL LYNN (D AC)
Entity Type:Individual
Prefix:MS
First Name:JEWEL
Middle Name:LYNN
Last Name:SOMMERVILLE
Suffix:
Gender:F
Credentials:D AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5835 POST RD
Mailing Address - Street 2:SUITE 113
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-2154
Mailing Address - Country:US
Mailing Address - Phone:401-398-2933
Mailing Address - Fax:
Practice Address - Street 1:5835 POST RD
Practice Address - Street 2:SUITE 113
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-2154
Practice Address - Country:US
Practice Address - Phone:401-398-2933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDA00186171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist