Provider Demographics
NPI:1417512575
Name:CHINA SPRING ACUPUNCTURE & HERBAL MEDICINE, LLC
Entity Type:Organization
Organization Name:CHINA SPRING ACUPUNCTURE & HERBAL MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:L.AC
Authorized Official - Prefix:
Authorized Official - First Name:QIN
Authorized Official - Middle Name:
Authorized Official - Last Name:YAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-698-0419
Mailing Address - Street 1:7102 FRIENDSHIP LN
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-1013
Mailing Address - Country:US
Mailing Address - Phone:608-698-0419
Mailing Address - Fax:
Practice Address - Street 1:5555 ODANA RD STE 209
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53719-1280
Practice Address - Country:US
Practice Address - Phone:608-698-0419
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-04
Last Update Date:2019-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty