MEDICARE: CHINESE MASSAGE & ACUPRESSURE

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	0121000655	VA

General Provider Information

NPI Number	:	1386027035
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHINESE MASSAGE & ACUPRESSURE

Provider Business Mailing Address
First Line	:	9419 BROAD MEADOWS RD
Second Line	:
City	:	GLEN ALLEN
State	:	VA
Zip	:	23060-3101
Country	:	US
Telephone Number	:	804-937-6738
Fax Number	:

Provider Business Practice Location Address
First Line	:	3601 MAYLAND CT
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23233-1409
Country	:	US
Telephone Number	:	804-937-6738
Fax Number	:

Authorized Official
Title or Position	:	MASSAGE THERAPY AND ACUPUNCTURIST
Name	:	YAN NIAN FAN
Credential	:	LAC
Telephone Number	:	804-937-6738

Provider Enumeration Date	:	06/30/2015
Last Update Date	:	01/30/2017

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