Provider Demographics
NPI:1619011335
Name:HU, YOUCHANG (AP)
Entity Type:Individual
Prefix:
First Name:YOUCHANG
Middle Name:
Last Name:HU
Suffix:
Gender:M
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2135 SOUTH RIDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH DAYTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32119-3015
Mailing Address - Country:US
Mailing Address - Phone:386-760-2112
Mailing Address - Fax:386-760-8722
Practice Address - Street 1:2135 SOUTH RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:SOUTH DAYTONA
Practice Address - State:FL
Practice Address - Zip Code:32119-3015
Practice Address - Country:US
Practice Address - Phone:386-760-2112
Practice Address - Fax:386-760-8722
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP 459171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist