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General NPI Number Information
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NPI Number | 1679852578
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Entity Type | Organization
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Legal Business Name | ACUPUNCTURE WANG CENTER
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Dates
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Enumeration Date | 08/09/2011
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Last Update Date | 08/09/2011
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Provider Practice Location Address
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Address Line | 2824 COTTMAN AVE STE 9
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City | PHILADELPHIA
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State | PA
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Zip | 19149-1400
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Country | US
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Telephone | 347-335-7885
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Fax |
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Provider Business Mailing Address
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Address Line | 2824 COTTMAN AVE STE 9
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City | PHILADELPHIA
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State | PA
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Zip | 19149-1400
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Country | US
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Telephone | 347-335-7885
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHUNWEI WANG
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Credential | ACUPUNCTURIST
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Telephone | 347-335-7885
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | KO 000631
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License Number State | PA
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