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NPI 1326686247

NPI 1326686247 : YIQIANG ZHOU LAC : AUGUSTA, GA

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General NPI Number Information
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    NPI Number           |    1326686247
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    Entity Type          |    Individual 
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    Provider Name        |    YIQIANG ZHOU LAC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/11/2019
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    Last Update Date     |    12/11/2019
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Provider Practice Location Address
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    Address Line         |    3540 WHEELER RD STE 505 
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    City                 |    AUGUSTA
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    State                |    GA
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    Zip                  |    30909-1890
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    Country              |    US
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    Telephone            |    706-993-3095
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    503 REGENT PL 
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    City                 |    AUGUSTA
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    State                |    GA
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    Zip                  |    30909-3112
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    Country              |    US
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    Telephone            |    706-951-1310
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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       |    458
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    License Number State |    GA
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