Provider Demographics
NPI:1497907570
Name:ACE ACUPUNCTURE CLINIC OF MILWAUKEE, LLC
Entity Type:Organization
Organization Name:ACE ACUPUNCTURE CLINIC OF MILWAUKEE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF ACUPUNCTURIST/DIRECTOR OF CAR
Authorized Official - Prefix:DR
Authorized Official - First Name:GUAN-YUAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, LAC
Authorized Official - Phone:414-438-9488
Mailing Address - Street 1:8412 W CAPITOL DR
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53222-1825
Mailing Address - Country:US
Mailing Address - Phone:414-438-9488
Mailing Address - Fax:262-821-1082
Practice Address - Street 1:8412 W CAPITOL DR
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53222-1825
Practice Address - Country:US
Practice Address - Phone:414-438-9488
Practice Address - Fax:262-821-1082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI549-04261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center