Provider Demographics
NPI:1093887044
Name:TAO, JIAHUA (LAC)
Entity Type:Individual
Prefix:MR
First Name:JIAHUA
Middle Name:
Last Name:TAO
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1138 E 72ND ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-5738
Mailing Address - Country:US
Mailing Address - Phone:912-355-1580
Mailing Address - Fax:912-355-1580
Practice Address - Street 1:1138 E 72ND ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-5738
Practice Address - Country:US
Practice Address - Phone:912-355-1580
Practice Address - Fax:912-355-1580
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA16171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist