Provider Demographics
NPI:1922571827
Name:MILLIS ACUPUNCTURE CENTER LLC
Entity Type:Organization
Organization Name:MILLIS ACUPUNCTURE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:YUANLING
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:LIC AC
Authorized Official - Phone:508-202-8447
Mailing Address - Street 1:969 MAIN ST UNIT 6
Mailing Address - Street 2:
Mailing Address - City:MILLIS
Mailing Address - State:MA
Mailing Address - Zip Code:02054-1555
Mailing Address - Country:US
Mailing Address - Phone:508-376-8208
Mailing Address - Fax:508-376-8160
Practice Address - Street 1:969 MAIN ST UNIT 6
Practice Address - Street 2:
Practice Address - City:MILLIS
Practice Address - State:MA
Practice Address - Zip Code:02054-1555
Practice Address - Country:US
Practice Address - Phone:508-376-8208
Practice Address - Fax:508-376-8160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-03
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center