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Individual

MR. PETSON CHAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LAC

Contact information

Practice address
19 W 21ST ST, SUITE 904, NEW YORK, NY 10010-6805
(347) 903-7059
Mailing address
19 W 21ST ST RM 904, NEW YORK, NY 10010-6851
(347) 903-7059

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
005317
NY

Other

Enumeration date
06/02/2014
Last updated
06/09/2015
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