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General NPI Number Information
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NPI Number | 1417273970
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Entity Type | Organization
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Legal Business Name | YI'S ACUPUNCTURE AND HERB CLINIC
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Dates
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Enumeration Date | 04/08/2010
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Last Update Date | 04/08/2010
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Provider Practice Location Address
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Address Line | 3540 WHEELER RD SUITE 505
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City | AUGUSTA
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State | GA
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Zip | 30909-1871
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Country | US
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Telephone | 706-993-3095
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Fax | 706-993-3095
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Provider Business Mailing Address
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Address Line | 3540 WHEELER RD SUITE 505
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City | AUGUSTA
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State | GA
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Zip | 30909-1871
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Country | US
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Telephone | 706-993-3095
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Fax | 706-993-3095
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Authorized Official
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Title or Position | L. AC.
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Name | MR. XIANDE YI
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Credential |
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Telephone | 706-993-3095
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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 | 000092
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License Number State | GA
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