Provider Demographics
NPI:1285278986
Name:ACU CHATT PLLC
Entity type:Organization
Organization Name:ACU CHATT PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:DWYER
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:423-708-5651
Mailing Address - Street 1:300 W MIDVALE AVE APT 7
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37405-4701
Mailing Address - Country:US
Mailing Address - Phone:727-543-6554
Mailing Address - Fax:
Practice Address - Street 1:1405 COWART ST STE 115
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37408-1177
Practice Address - Country:US
Practice Address - Phone:423-708-5651
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-05
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty