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General NPI Number Information
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NPI Number | 1497907570
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Entity Type | Organization
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Legal Business Name | ACE ACUPUNCTURE CLINIC OF MILWAUKEE, LLC
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Dates
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Enumeration Date | 10/21/2008
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Last Update Date | 10/21/2008
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Provider Practice Location Address
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Address Line | 8412 W CAPITOL DR
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City | MILWAUKEE
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State | WI
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Zip | 53222-1825
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Country | US
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Telephone | 414-438-9488
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Fax | 262-821-1082
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Provider Business Mailing Address
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Address Line | 8412 W CAPITOL DR
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City | MILWAUKEE
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State | WI
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Zip | 53222-1825
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Country | US
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Telephone | 414-438-9488
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Fax | 262-821-1082
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Authorized Official
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Title or Position | CHIEF ACUPUNCTURIST/DIRECTOR OF CAR
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Name | DR. GUAN-YUAN JIN
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Credential | MD, L.AC
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Telephone | 414-438-9488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 549-04
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License Number State | WI
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