Healthcare Provider Details

I. General information

NPI: 1568889533
Provider Name (Legal Business Name): JULIAN ZHU L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2014
Last Update Date: 04/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17269 WILD HORSE CREEK RD SUITE 140
CHESTERFIELD MO
63005-1360
US

IV. Provider business mailing address

1154 HOLLOW VALLEY CT
SAINT CHARLES MO
63304-2466
US

V. Phone/Fax

Practice location:
  • Phone: 314-477-6688
  • Fax:
Mailing address:
  • Phone: 314-477-6688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number2012039671
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: