Provider Demographics
NPI:1710248562
Name:TCM ACUPUNCTURE CLINIC
Entity Type:Organization
Organization Name:TCM ACUPUNCTURE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AP
Authorized Official - Prefix:
Authorized Official - First Name:HONG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-399-5728
Mailing Address - Street 1:8603 S DIXIE HWY STE 208
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-7860
Mailing Address - Country:US
Mailing Address - Phone:651-399-5728
Mailing Address - Fax:305-661-4771
Practice Address - Street 1:8603 S DIXIE HWY STE 208
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-7860
Practice Address - Country:US
Practice Address - Phone:651-399-5728
Practice Address - Fax:305-661-4771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3112171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty