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General NPI Number Information
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NPI Number | 1790062107
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Entity Type | Organization
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Legal Business Name | ACADEMY OF ACUPUNCTURE & CHINESE MEDICINE, LLC
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Dates
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Enumeration Date | 11/14/2011
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Last Update Date | 11/14/2011
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Provider Practice Location Address
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Address Line | 6410 ROCKLEDGE DR SUITE 418
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City | BETHESDA
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State | MD
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Zip | 20817-1809
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Country | US
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Telephone | 301-530-5308
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Fax | 301-564-5808
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Provider Business Mailing Address
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Address Line | 6410 ROCKLEDGE DR SUITE 418
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City | BETHESDA
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State | MD
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Zip | 20817-1809
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Country | US
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Telephone | 301-530-5308
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Fax | 301-564-5808
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Authorized Official
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Title or Position | DIRECTOR
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Name | XIAOMING TIAN
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Credential | L.AC.
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Telephone | 301-530-5308
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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 | U01837
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | U214
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License Number State | MD
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