Healthcare Provider Details

I. General information

NPI: 1417427964
Provider Name (Legal Business Name): ACUPANDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2018
Last Update Date: 11/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1102 STEPHENSON LN # 100
WAUNAKEE WI
53597-2515
US

IV. Provider business mailing address

1415 SPAHN DR
WAUNAKEE WI
53597-3011
US

V. Phone/Fax

Practice location:
  • Phone: 608-960-8512
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: HONG ZHANG
Title or Position: OWNER
Credential: LAC, LMT
Phone: 608-960-8512