Provider Demographics
NPI:1881214120
Name:LUO, CHI LIANG (LMT)
Entity Type:Individual
Prefix:
First Name:CHI LIANG
Middle Name:
Last Name:LUO
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 LINCOLN ST STE 401
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-2422
Mailing Address - Country:US
Mailing Address - Phone:617-953-6377
Mailing Address - Fax:
Practice Address - Street 1:200 LINCOLN ST STE 401
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-2422
Practice Address - Country:US
Practice Address - Phone:617-953-6377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-16
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA955225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty