Provider Demographics
NPI:1578017109
Name:YAN ACUPUNCTURE& HERBS LLC
Entity Type:Organization
Organization Name:YAN ACUPUNCTURE& HERBS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:CHUNLING
Authorized Official - Middle Name:
Authorized Official - Last Name:YAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-244-3290
Mailing Address - Street 1:4000 NW 51ST ST
Mailing Address - Street 2:APT. J178
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-4333
Mailing Address - Country:US
Mailing Address - Phone:571-244-3290
Mailing Address - Fax:
Practice Address - Street 1:4210 NW 37TH PL
Practice Address - Street 2:SUITE 200
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-7700
Practice Address - Country:US
Practice Address - Phone:352-872-5556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-11
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3731171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty