Provider Demographics
NPI:1891152211
Name:DAI, JEAN PEIJIN (RAC)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:PEIJIN
Last Name:DAI
Suffix:
Gender:F
Credentials:RAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4930 N RIDGESIDE CIR
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9446
Mailing Address - Country:US
Mailing Address - Phone:734-788-6889
Mailing Address - Fax:734-668-2168
Practice Address - Street 1:4930 N RIDGESIDE CIR
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-9446
Practice Address - Country:US
Practice Address - Phone:734-788-6889
Practice Address - Fax:734-668-2168
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-16
Last Update Date:2016-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5401000108171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist