Individual
JEREMY PAUL MIERISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.AC,,MS
Contact information
Practice address
10 DAHLIA DR W, EAST PATCHOGUE, NY 11772-4860
(631) 835-2415
(631) 627-3960
Mailing address
10 DAHLIA DR W, EAST PATCHOGUE, NY 11772-4860
(631) 835-2415
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
005062
NY
Other
Enumeration date
05/23/2013
Last updated
05/23/2013
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