Organization
ONE MOON INC
Active
Other names
Vita whole body care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDY M GONZALES LAC (ACUPUNCTURIST)
(631) 875-7200
Entity
Organization
Contact information
Practice address
750 ROUTE 25A, EAST SETAUKET, NY 11733-1239
(631) 364-9075
Mailing address
820 SUFFOLK AVE STE 201, BRENTWOOD, NY 11717-4498
(631) 524-5224
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
—
Other
Enumeration date
08/31/2017
Last updated
06/16/2018
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