Provider Demographics
NPI:1225395767
Name:FANG, ZUI (LAC)
Entity Type:Individual
Prefix:
First Name:ZUI
Middle Name:
Last Name:FANG
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 1:181 GRANVILLE ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-2967
Mailing Address - Country:US
Mailing Address - Phone:614-209-4668
Mailing Address - Fax:
Practice Address - Street 1:181 GRANVILLE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-2967
Practice Address - Country:US
Practice Address - Phone:614-209-4668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH65.000131171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist