Provider Demographics
NPI:1114191301
Name:LIU, YUANLING (ACUPUNCTURIST)
Entity Type:Individual
Prefix:
First Name:YUANLING
Middle Name:
Last Name:LIU
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:969 MAIN ST. SUITE 6
Mailing Address - Street 2:
Mailing Address - City:MILLIS
Mailing Address - State:MA
Mailing Address - Zip Code:02054
Mailing Address - Country:US
Mailing Address - Phone:508-202-8447
Mailing Address - Fax:
Practice Address - Street 1:10 MAIN ST
Practice Address - Street 2:
Practice Address - City:NORTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01532-1970
Practice Address - Country:US
Practice Address - Phone:508-351-1655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-17
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA303133V00000X
MA230120171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered