Individual
MRS. PHYLLIS MARIE MORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC.
Contact information
Practice address
667 ROUTE 292, HOLMES, NY 12531-5342
(914) 282-8493
Mailing address
667 ROUTE 292, HOLMES, NY 12531-5342
(914) 282-8493
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
006053-1
NY
Other
Enumeration date
01/26/2019
Last updated
01/26/2019
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