Provider Demographics
NPI:1255988853
Name:ZHOU NIEMTZOW, SONGXUAN (LAC)
Entity type:Individual
Prefix:
First Name:SONGXUAN
Middle Name:
Last Name:ZHOU NIEMTZOW
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 ELM ST SW
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-6315
Mailing Address - Country:US
Mailing Address - Phone:240-460-5868
Mailing Address - Fax:
Practice Address - Street 1:ACUPUNCTURE AND INTEGRATIVE MEDICINE CENTER
Practice Address - Street 2:1060 WEST PERIMETER ROAD
Practice Address - City:JOINT BASE ANDREWS
Practice Address - State:MD
Practice Address - Zip Code:20762
Practice Address - Country:US
Practice Address - Phone:619-647-7274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-20
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INU02424171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist