Healthcare Provider Details
I. General information
NPI: 1215716212
Provider Name (Legal Business Name): BEIJING ACUPUNCTURE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/27/2023
Last Update Date: 09/27/2023
Certification Date: 09/27/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2645 N BERKELEY LAKE RD NW STE 133
DULUTH GA
30096-1461
US
IV. Provider business mailing address
2645 N BERKELEY LAKE RD NW STE 133
DULUTH GA
30096-1461
US
V. Phone/Fax
- Phone: 770-814-9898
- Fax: 770-200-1610
- Phone: 770-814-9898
- Fax: 770-200-1610
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
FUZI
GAO
Title or Position: MANAGER
Credential: LAC
Phone: 770-814-9898