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Individual

MR. WADE NEWTON DE LOE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.S.,L.AC.

Contact information

Practice address
560 W 170TH ST, SUITE 6B, NEW YORK, NY 10032-3324
(718) 877-0292
Mailing address
560 W 170TH ST, SUITE 6B, NEW YORK, NY 10032-3324
(718) 877-0292

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
003718-1
NY
171100000X
Acupuncturist
KO000619
PA

Other

Enumeration date
10/26/2009
Last updated
10/26/2009
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