Provider Demographics
NPI:1356033955
Name:MAIN LINE ACUPUNCTURE & ORIENTAL MEDICINE
Entity type:Organization
Organization Name:MAIN LINE ACUPUNCTURE & ORIENTAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DONGXIAO
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:LOM
Authorized Official - Phone:215-869-7223
Mailing Address - Street 1:28 W LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19003-2355
Mailing Address - Country:US
Mailing Address - Phone:610-642-8888
Mailing Address - Fax:
Practice Address - Street 1:28 W LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:PA
Practice Address - Zip Code:19003-2355
Practice Address - Country:US
Practice Address - Phone:610-642-8888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty