MEDICARE: DIWUCY LIU L.AC.

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	84000126A	IN

General Provider Information

NPI Number	:	1548536931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIWUCY LIU L.AC.

Provider Business Mailing Address
First Line	:	10124 MEDALLION DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46231-1923
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10124 MEDALLION DR
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46231-1923
Country	:	US
Telephone Number	:	317-445-7137
Fax Number	:

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

Provider Enumeration Date	:	03/29/2012
Last Update Date	:	03/29/2012

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Directions to “ DIWUCY LIU L.AC.” Practice Location

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