Healthcare Provider Details

I. General information

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

II. Dates (important events)

Enumeration Date: 07/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2960 W GERMANTOWN PIKE
NORRISTOWN PA
19403-1037
US

IV. Provider business mailing address

2960 W GERMANTOWN PIKE
NORRISTOWN PA
19403-1037
US

V. Phone/Fax

Practice location:
  • Phone: 610-505-5188
  • Fax: 610-630-8557
Mailing address:
  • Phone: 610-505-5188
  • Fax: 610-630-8557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAK00686
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: