Provider Demographics
NPI:1922491380
Name:OSANO, AKINYI (DAC, LAC DOM)
Entity Type:Individual
Prefix:DR
First Name:AKINYI
Middle Name:
Last Name:OSANO
Suffix:
Gender:F
Credentials:DAC, LAC DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6864
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30154-0032
Mailing Address - Country:US
Mailing Address - Phone:888-871-1884
Mailing Address - Fax:888-871-1884
Practice Address - Street 1:7193 DOUGLAS BLVD STE 206
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-1540
Practice Address - Country:US
Practice Address - Phone:888-871-1884
Practice Address - Fax:888-871-1884
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA325171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist