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NPI Code Detail

MEDICARE: AZURE DUAN L.AC., DIPL. O.M.

MEDICARE: AZURE DUAN L.AC., DIPL. O.M.
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
1171100000XAcupuncturist000362GA

General Provider Information

NPI Number : 1518348044
Entity Type Code : Individual
Provider Name (Legal Business Name) : AZURE DUAN L.AC., DIPL. O.M.
Provider Business Mailing Address
First Line : 1838 OLD NORCROSS RD STE 300
Second Line :
City : LAWRENCEVILLE
State : GA
Zip : 30044-8804
Country : US
Telephone Number : 770-310-8070
Fax Number :
Provider Business Practice Location Address
First Line : 1838 OLD NORCROSS RD STE 300
Second Line :
City : LAWRENCEVILLE
State : GA
Zip : 30044-8804
Country : US
Telephone Number : 770-310-8070
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2015
Last Update Date : 06/10/2015

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Directions to “ AZURE DUAN L.AC., DIPL. O.M.” Practice Location

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