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General NPI Number Information
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NPI Number | 1760873178
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Entity Type | Individual
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Provider Name | WENYAO SHI L.AC.
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Gender | Male
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Dates
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Enumeration Date | 02/08/2015
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Last Update Date | 04/18/2016
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Provider Practice Location Address
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Address Line | 7635 LEESBURG PIKE SUITE A
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City | FALLS CHURCH
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State | VA
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Zip | 22043-2520
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Country | US
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Telephone | 571-969-2684
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Fax | 703-893-8809
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Provider Business Mailing Address
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Address Line | 7102 SEA CLIFF RD
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City | MC LEAN
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State | VA
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Zip | 22101-5030
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Country | US
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Telephone | 571-969-2684
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Fax | 703-893-8809
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 0121000762
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License Number State | VA
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