Individual
MIRA TATYANA STANCHAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.A.O.M.
Contact information
Practice address
65 COTTAGE ST APT 1, WATERTOWN, MA 02472-1513
(671) 824-0746
Mailing address
65 COTTAGE ST APT 1, WATERTOWN, MA 02472-1513
(671) 824-0746
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
—
Other
Enumeration date
01/14/2011
Last updated
01/14/2011
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