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General NPI Number Information
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NPI Number | 1982116521
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Entity Type | Organization
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Legal Business Name | EMED CLINIC, LLC.
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Dates
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Enumeration Date | 11/03/2017
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Last Update Date | 08/30/2019
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Provider Practice Location Address
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Address Line | 604 W WARNER RD STE B1
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City | CHANDLER
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State | AZ
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Zip | 85225-2913
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Country | US
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Telephone | 480-429-8881
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Fax | 480-429-8882
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Provider Business Mailing Address
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Address Line | 3225 N 75TH ST STE 115
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-6928
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Country | US
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Telephone | 480-429-8881
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Fax | 480-429-8882
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Authorized Official
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Title or Position | DIRECTOR
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Name | QINGSONG XIAO
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Credential | O.M.D., PH.D., L.AC
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Telephone | 480-429-8881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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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 |
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License Number State |
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