Provider Demographics
NPI:1245992114
Name:TIAN, MIN (ACUPUNCTURIST)
Entity type:Individual
Prefix:MRS
First Name:MIN
Middle Name:
Last Name:TIAN
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:362 OFFICE PLAZA DRIVE
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301
Mailing Address - Country:US
Mailing Address - Phone:850-894-8999
Mailing Address - Fax:850-219-8990
Practice Address - Street 1:362 OFFICE PLAZA DRIVE
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301
Practice Address - Country:US
Practice Address - Phone:850-894-8999
Practice Address - Fax:850-219-8990
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-08
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1481171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty