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General NPI Number Information
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NPI Number | 1255988853
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Entity Type | Individual
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Provider Name | SONGXUAN ZHOU NIEMTZOW LAC
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Gender | Female
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Dates
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Enumeration Date | 08/20/2019
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Last Update Date | 07/16/2024
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Provider Practice Location Address
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Address Line | ACUPUNCTURE AND INTEGRATIVE MEDICINE CENTER 1060 WEST PERIMETER ROAD
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City | JOINT BASE ANDREWS
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State | MD
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Zip | 20762
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Country | US
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Telephone | 619-647-7274
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Fax |
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Provider Business Mailing Address
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Address Line | 105 ELM ST SW
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City | VIENNA
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State | VA
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Zip | 22180-6315
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Country | US
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Telephone | 240-460-5868
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | U02424
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License Number State | IN
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