Healthcare Provider Details

I. General information

NPI: 1417155102
Provider Name (Legal Business Name): RUIJUAN LIU L.AC., O.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2007
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 N BROAD ST
LANSDALE PA
19446-2416
US

IV. Provider business mailing address

506 N BROAD ST
LANSDALE PA
19446-2416
US

V. Phone/Fax

Practice location:
  • Phone: 610-505-5188
  • Fax: 814-205-2483
Mailing address:
  • Phone: 610-505-5188
  • Fax: 814-205-2483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAK000686
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: