Healthcare Provider Details

I. General information

NPI: 1285902023
Provider Name (Legal Business Name): GUANHU YANG ACUPUNCTURE SERVICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2011
Last Update Date: 12/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5887 CORNELL RD UNIT 4,
CINCINNATI OH
45242
US

IV. Provider business mailing address

7201 CAMARGO GREENE CT
CINCINNATI OH
45243-2237
US

V. Phone/Fax

Practice location:
  • Phone: 513-652-5688
  • Fax: 888-847-1235
Mailing address:
  • Phone: 513-652-5688
  • Fax: 888-847-1235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number65.000077
License Number StateOH

VIII. Authorized Official

Name: MR. GUANHU YANG
Title or Position: OWNER
Credential: L.AC.
Phone: 513-652-5688