Individual
MARISA ANDERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.AC
Contact information
Practice address
412 N COUNTRY RD, SUITE 8, SAINT JAMES, NY 11780-1761
(631) 355-9763
Mailing address
52 VANDERBILT AVE, SAINT JAMES, NY 11780-1732
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
005829
NY
Other
Enumeration date
09/19/2016
Last updated
12/07/2016
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