Provider Demographics
NPI:1609917210
Name:LIN, CHYI-SHYANG (LAC DIPLCH&OM)
Entity Type:Individual
Prefix:MR
First Name:CHYI-SHYANG
Middle Name:
Last Name:LIN
Suffix:
Gender:M
Credentials:LAC DIPLCH&OM
Other - Prefix:
Other - First Name:PAUL
Other - Middle Name:
Other - Last Name:LIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3022 OLD ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54703-6602
Mailing Address - Country:US
Mailing Address - Phone:715-456-4772
Mailing Address - Fax:
Practice Address - Street 1:3004 GOLF RD
Practice Address - Street 2:SUITE 100
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-8793
Practice Address - Country:US
Practice Address - Phone:715-836-4516
Practice Address - Fax:715-834-0552
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI302055171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist