Individual
LISA WILTSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC., DIPL.AC.
Contact information
Practice address
43 E 10TH ST APT 6H, NEW YORK, NY 10003-6106
(212) 804-7267
(212) 518-0578
Mailing address
82 NASSAU ST STE 208, NEW YORK, NY 10038-3703
(620) 353-8487
(212) 518-0578
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007338-01
NY STATE ACUPUNCTURIST LICENSE
NY
Enumeration date
05/22/2023
Last updated
12/22/2023
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