Healthcare Provider Details

I. General information

NPI: 1114191301
Provider Name (Legal Business Name): YUANLING LIU ACUPUNCTURIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2008
Last Update Date: 05/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 MAIN ST
NORTHBOROUGH MA
01532-1970
US

IV. Provider business mailing address

969 MAIN ST. SUITE 6
MILLIS MA
02054
US

V. Phone/Fax

Practice location:
  • Phone: 508-351-1655
  • Fax:
Mailing address:
  • Phone: 508-202-8447
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number303
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number230120
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: