Provider Demographics
NPI:1649446071
Name:WESTMORELAND, JIM (LAC)
Entity type:Individual
Prefix:MR
First Name:JIM
Middle Name:
Last Name:WESTMORELAND
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1360 VINEYARD RD
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30223-8023
Mailing Address - Country:US
Mailing Address - Phone:770-227-7907
Mailing Address - Fax:
Practice Address - Street 1:1360 VINEYARD RD
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30223-8023
Practice Address - Country:US
Practice Address - Phone:770-227-7907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000054171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist