MEDICARE: YING WANG LAC

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	028	TN

General Provider Information

NPI Number	:	1578707808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YING WANG LAC

Provider Business Mailing Address
First Line	:	890 SUN VISTA DR E
Second Line	:
City	:	CORDOVA
State	:	TN
Zip	:	38018-3522
Country	:	US
Telephone Number	:	901-751-1353
Fax Number	:	901-751-1353

Provider Business Practice Location Address
First Line	:	8066 WALNUT RUN RD
Second Line	:	SUITE 102
City	:	CORDOVA
State	:	TN
Zip	:	38018-8841
Country	:	US
Telephone Number	:	901-463-0566
Fax Number	:

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

Provider Enumeration Date	:	04/30/2009
Last Update Date	:	04/30/2009

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Directions to “ YING WANG LAC” Practice Location

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