Healthcare Provider Details

I. General information

NPI: 1396076014
Provider Name (Legal Business Name): YUSHENG QIAO L. AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2010
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 PIRKLE FERRY RD STE E
CUMMING GA
30040-9236
US

IV. Provider business mailing address

11240 ABBOTTS STATION DR
JOHNS CREEK GA
30097-5717
US

V. Phone/Fax

Practice location:
  • Phone: 404-728-8896
  • Fax: 844-803-0063
Mailing address:
  • Phone: 404-402-9007
  • Fax: 844-803-0063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number14
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: