Individual
STACEY VANGORDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
211 GRAND ST, NEW YORK, NY 10013-4223
(917) 365-0304
Mailing address
211 GRAND ST, NEW YORK, NY 10013-4223
(917) 365-0304
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
0028771
NY
Other
Enumeration date
07/01/2008
Last updated
07/01/2008
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