MEDICARE: TIEQIANG ZHAO LAC

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
1	171100000X	Acupuncturist	578	TN

General Provider Information

NPI Number	:	1275475634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIEQIANG ZHAO LAC

Provider Business Mailing Address
First Line	:	399 FOUNTAIN CREST DR
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38120-1840
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	985 CORDOVA STATION AVE STE 101
Second Line	:
City	:	CORDOVA
State	:	TN
Zip	:	38018-3105
Country	:	US
Telephone Number	:	901-340-6433
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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Directions to “ TIEQIANG ZHAO LAC” Practice Location

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