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Organization
ANCIENT WIDOM HEALING ARTS
Active
Organization
ANCIENT WIDOM HEALING ARTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN WILSON BROUSSARD L. AC., M.T.O.M. (VICE PRESIDENT)
(443) 838-3141
Entity
Organization
Contact information
Practice address
658 KENILWORTH DR, SUITE #102, TOWSON, MD 21204-2312
(443) 838-3141
(410) 377-6168
Mailing address
918 WELLINGTON RD, BALTIMORE, MD 21212-1921
(443) 838-3141
(410) 377-6168
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
LIC # U01120
MD
Other
Enumeration date
02/12/2015
Last updated
02/12/2015
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