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NPI Code Detail

MEDICARE: VICKY LEE L.AC.

MEDICARE:   VICKY  LEE  L.AC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171100000XAcupuncturist15924CA
2171100000XAcupuncturist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
115924OTHERCACALIFORNIA ACUPUNCTURE BOARD

General Provider Information

NPI Number : 1093135303
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICKY LEE L.AC.
Provider Business Mailing Address
First Line : 1906 N. HAMILTON ST. STE E
Second Line :
City : RICHMOND
State : VA
Zip : 23230-4113
Country : US
Telephone Number : 804-200-4054
Fax Number : 619-795-4423
Provider Business Practice Location Address
First Line : 1906 N HAMILTON ST. STE E
Second Line :
City : RICHMOND
State : VA
Zip : 23230-4113
Country : US
Telephone Number : 804-200-4054
Fax Number : 619-795-4423
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2014
Last Update Date : 03/16/2018

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Directions to “ VICKY LEE L.AC.” Practice Location

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