Provider Demographics
NPI:1457781981
Name:ACU-MED INTEGRATIVE MEDICINE LLC
Entity Type:Organization
Organization Name:ACU-MED INTEGRATIVE MEDICINE LLC
Other - Org Name:ACUPUNCTURE & CHINESE MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:XUEFEN
Authorized Official - Middle Name:
Authorized Official - Last Name:REX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-832-8888
Mailing Address - Street 1:1720 DOLPHIN DR STE B
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53186-1489
Mailing Address - Country:US
Mailing Address - Phone:262-832-8888
Mailing Address - Fax:
Practice Address - Street 1:1428 E RACINE AVE
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53186-6462
Practice Address - Country:US
Practice Address - Phone:262-832-8888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-19
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI491055171100000X
WI713-055171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty