Provider Demographics
NPI:1417273970
Name:YI'S ACUPUNCTURE AND HERB CLINIC
Entity Type:Organization
Organization Name:YI'S ACUPUNCTURE AND HERB CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:L. AC.
Authorized Official - Prefix:MR
Authorized Official - First Name:XIANDE
Authorized Official - Middle Name:
Authorized Official - Last Name:YI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-993-3095
Mailing Address - Street 1:3540 WHEELER RD
Mailing Address - Street 2:SUITE 505
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-1871
Mailing Address - Country:US
Mailing Address - Phone:706-993-3095
Mailing Address - Fax:706-993-3095
Practice Address - Street 1:3540 WHEELER RD
Practice Address - Street 2:SUITE 505
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-1871
Practice Address - Country:US
Practice Address - Phone:706-993-3095
Practice Address - Fax:706-993-3095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-08
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000092171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty