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General NPI Number Information
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NPI Number | 1386027035
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Entity Type | Organization
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Legal Business Name | CHINESE MASSAGE & ACUPRESSURE
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Dates
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Enumeration Date | 06/30/2015
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Last Update Date | 01/30/2017
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Provider Practice Location Address
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Address Line | 3601 MAYLAND CT
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City | HENRICO
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State | VA
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Zip | 23233-1409
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Country | US
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Telephone | 804-937-6738
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Fax |
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Provider Business Mailing Address
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Address Line | 9419 BROAD MEADOWS RD
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City | GLEN ALLEN
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State | VA
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Zip | 23060-3101
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Country | US
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Telephone | 804-937-6738
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Fax |
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Authorized Official
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Title or Position | MASSAGE THERAPY AND ACUPUNCTURIST
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Name | YAN NIAN FAN
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Credential | LAC
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Telephone | 804-937-6738
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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 | 0121000655
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License Number State | VA
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