MEDICARE: JC ACUPUNCTURE & CHINESE HERB CENTER

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

General Provider Information

NPI Number	:	1396330528
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JC ACUPUNCTURE & CHINESE HERB CENTER

Provider Business Mailing Address
First Line	:	1120 NEW HAMPSHIRE AVE
Second Line	:	#502
City	:	SILVER SPRING
State	:	MD
Zip	:	20904
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1120 NEW HAMPSHIRE AVE
Second Line	:	#502
City	:	SILVER SPRING
State	:	MD
Zip	:	20904
Country	:	US
Telephone Number	:	301-592-0036
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MISS JIE CHEN
Credential	:	LIC ACUPUNCTURIST
Telephone Number	:	301-512-0036

Provider Enumeration Date	:	03/09/2021
Last Update Date	:	03/09/2021

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