Organization
WELLSPRING OF LIFE ACUPUNCTURE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA PETERS L.AC. (OWNER, PRESIDENT)
(631) 896-0403
Entity
Organization
Contact information
Practice address
2171 JERICHO TPKE, SUITE 135, COMMACK, NY 11725-2937
(631) 670-6690
Mailing address
PO BOX 2236, AQUEBOGUE, NY 11931-2236
(631) 896-0403
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
004487
NY
Other
Enumeration date
03/03/2017
Last updated
03/03/2017
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