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General NPI Number Information
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NPI Number | 1558811398
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Entity Type | Organization
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Legal Business Name | SUN TRAD CHIN ACU LLC
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Dates
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Enumeration Date | 10/05/2016
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Last Update Date | 10/05/2016
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Provider Practice Location Address
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Address Line | 128 S MAIN ST
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City | RIVER FALLS
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State | WI
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Zip | 54022-3492
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Country | US
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Telephone | 715-629-2108
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Fax | 715-629-2087
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Provider Business Mailing Address
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Address Line | 128 S MAIN ST
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City | RIVER FALLS
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State | WI
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Zip | 54022-3492
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Country | US
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Telephone | 715-629-2108
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Fax | 715-629-2087
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Authorized Official
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Title or Position | ACUPUNCTURIST AND OWNER
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Name | DR. XIAOYAN LIU
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Credential | PHD.
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Telephone | 715-629-2108
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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 | 88555
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License Number State | WI
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