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Individual

IDALEE WAGMAN DIGREGORIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
L.AC

Contact information

Practice address
715 PARK AVE, BALTIMORE, MD 21201-4711
(410) 454-0178
(443) 552-0319
Mailing address
1804 WALNUT RD, BALTIMORE, MD 21209-3534
(410) 454-0178
(443) 552-0319

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
U01942
MD

Other

Enumeration date
10/25/2011
Last updated
04/24/2012
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