Provider Demographics
NPI:1932119757
Name:JLW,INC
Entity Type:Organization
Organization Name:JLW,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:SADLER
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, MAC, DIPLAC
Authorized Official - Phone:757-428-4286
Mailing Address - Street 1:837 FIRST COLONIAL RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-6195
Mailing Address - Country:US
Mailing Address - Phone:757-428-4286
Mailing Address - Fax:757-428-4286
Practice Address - Street 1:837 FIRST COLONIAL RD
Practice Address - Street 2:SUITE A
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-6195
Practice Address - Country:US
Practice Address - Phone:757-428-4286
Practice Address - Fax:757-428-4286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000281171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty