Provider Demographics
NPI:1497596027
Name:ZHOU, PHILLIP LI (LAC)
Entity type:Individual
Prefix:MR
First Name:PHILLIP
Middle Name:LI
Last Name:ZHOU
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 GREEN TREE TAVERN RD
Mailing Address - Street 2:
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-1250
Mailing Address - Country:US
Mailing Address - Phone:215-264-0319
Mailing Address - Fax:
Practice Address - Street 1:210 GREEN TREE TAVERN RD
Practice Address - Street 2:
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454-1250
Practice Address - Country:US
Practice Address - Phone:215-264-0319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK001459171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist