Healthcare Provider Details

I. General information

NPI: 1841351004
Provider Name (Legal Business Name): DANCHENG ZHU LIC.AC., LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 05/19/2022
Certification Date: 05/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

697 CAMBRIDGE ST SUITE 202
BRIGHTON MA
02135-2897
US

IV. Provider business mailing address

697 CAMBRIDGE ST STE 303
BRIGHTON MA
02135-2897
US

V. Phone/Fax

Practice location:
  • Phone: 617-309-9901
  • Fax:
Mailing address:
  • Phone: 617-309-9901
  • Fax: 617-787-4881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number2448
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number236593
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: