Provider Demographics
NPI:1093984445
Name:TU, CHUN S (LIC AC)
Entity Type:Individual
Prefix:
First Name:CHUN
Middle Name:S
Last Name:TU
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 PINE SWAMP RD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-1001
Mailing Address - Country:US
Mailing Address - Phone:508-399-8880
Mailing Address - Fax:
Practice Address - Street 1:ACUPUNCTURE CENTER
Practice Address - Street 2:668 NEWPORT AVENUE
Practice Address - City:S. ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703
Practice Address - Country:US
Practice Address - Phone:508-399-8880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-29
Last Update Date:2008-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA93171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist