Individual
BISHARA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSTOM, L.AC.
Contact information
Practice address
493 QUINCY ST, BROOKLYN, NY 11221-1505
(347) 200-0594
Mailing address
493 QUINCY ST, BROOKLYN, NY 11221-1505
(347) 200-0594
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
002441
NY
Other
Enumeration date
09/21/2007
Last updated
12/12/2012
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