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General NPI Number Information
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NPI Number | 1417512575
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Entity Type | Organization
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Legal Business Name | CHINA SPRING ACUPUNCTURE & HERBAL MEDICINE, LLC
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Dates
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Enumeration Date | 05/04/2019
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Last Update Date | 05/04/2019
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Provider Practice Location Address
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Address Line | 5555 ODANA RD STE 209
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City | MADISON
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State | WI
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Zip | 53719-1280
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Country | US
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Telephone | 608-698-0419
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Fax |
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Provider Business Mailing Address
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Address Line | 7102 FRIENDSHIP LN
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City | MIDDLETON
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State | WI
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Zip | 53562-1013
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Country | US
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Telephone | 608-698-0419
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Fax |
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Authorized Official
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Title or Position | L.AC
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Name | QIN YAN
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Credential |
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Telephone | 608-698-0419
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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 |
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License Number State |
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