Healthcare Provider Details

I. General information

NPI: 1841410313
Provider Name (Legal Business Name): BRIAN C ALLEN MSTOM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 CASIMIR DR
HISTORIC NEW CASTLE DE
19720-4521
US

IV. Provider business mailing address

110 CASIMIR DR
HISTORIC NEW CASTLE DE
19720-4521
US

V. Phone/Fax

Practice location:
  • Phone: 302-792-2831
  • Fax: 302-792-2831
Mailing address:
  • Phone: 302-792-2831
  • Fax: 302-792-2831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: