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General NPI Number Information
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NPI Number | 1225178643
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Entity Type | Organization
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Legal Business Name | PAN'S ACUPUNCTURE & HERBS LLC
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2422 BRISTOL RD
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City | BENSALEM
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State | PA
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Zip | 19020-6002
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Country | US
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Telephone | 215-718-8988
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Fax |
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Provider Business Mailing Address
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Address Line | 2501 NASHUA RD SUITE 8
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City | BENSALEM
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State | PA
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Zip | 19020-2260
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Country | US
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Telephone | 215-718-8988
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NINA NING PAN
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Credential | L.AC.
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Telephone | 215-718-8988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AK000632
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License Number State | PA
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