Provider Demographics
NPI:1891565305
Name:FU, XINGCHEN (DC)
Entity Type:Individual
Prefix:
First Name:XINGCHEN
Middle Name:
Last Name:FU
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:ANDY
Other - Middle Name:
Other - Last Name:FU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:191 NW WILLOW GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-3564
Mailing Address - Country:US
Mailing Address - Phone:860-924-9882
Mailing Address - Fax:
Practice Address - Street 1:191 NW WILLOW GROVE AVE
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-3564
Practice Address - Country:US
Practice Address - Phone:860-924-9882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-05
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH14827111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor