Organization
WOLF MOON INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MARY SCHMAELING L.AC. (VICE PRESIDENT)
(516) 581-7013
Entity
Organization
Contact information
Practice address
875 W JERICHO TPKE, SMITHTOWN, NY 11787-3229
(516) 581-7013
Mailing address
321 DEER RD, RONKONKOMA, NY 11779-4962
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
4901
NY
Other
Enumeration date
10/15/2014
Last updated
10/15/2014
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