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General NPI Number Information
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NPI Number | 1396076014
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Entity Type | Individual
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Provider Name | YUSHENG QIAO L. AC.
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Gender | Male
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Dates
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Enumeration Date | 01/20/2010
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Last Update Date | 01/20/2010
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Provider Practice Location Address
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Address Line | 5677 BUFORD HWY NE SUITE 210
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City | DORAVILLE
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State | GA
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Zip | 30340-1244
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Country | US
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Telephone | 404-402-9007
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Fax | 678-374-1963
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Provider Business Mailing Address
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Address Line | 11240 ABBOTTS STATION DR
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City | JOHNS CREEK
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State | GA
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Zip | 30097-5717
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Country | US
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Telephone | 404-402-9007
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Fax | 678-374-1963
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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 | 14
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License Number State | GA
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