Individual
EDWIN WONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
6015 W 45TH AVE, #B, AMARILLO, TX 79109-5117
(806) 352-0225
Mailing address
6015 W 45TH AVE, B, AMARILLO, TX 79109
(806) 352-0225
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
00190
TX
Other
Enumeration date
04/10/2007
Last updated
07/08/2007
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