MEDICARE: QINGPING CHEN L. AC., PH.D.

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	65-00-0051	OH

General Provider Information

NPI Number	:	1386683878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	QINGPING CHEN L. AC., PH.D.

Provider Business Mailing Address
First Line	:	2405 FULTON RD NW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44709-3425
Country	:	US
Telephone Number	:	330-454-3940
Fax Number	:

Provider Business Practice Location Address
First Line	:	2405 FULTON RD NW
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44709-3425
Country	:	US
Telephone Number	:	330-454-3940
Fax Number	:

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

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	06/02/2011

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