Provider Demographics
NPI:1649869710
Name:CHI, TING TING (MSTOM, RAC)
Entity type:Individual
Prefix:
First Name:TING TING
Middle Name:
Last Name:CHI
Suffix:
Gender:F
Credentials:MSTOM, RAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:28455 HAGGERTY RD STE 200
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-2982
Mailing Address - Country:US
Mailing Address - Phone:248-893-3200
Mailing Address - Fax:248-893-2950
Practice Address - Street 1:28455 HAGGERTY RD STE 200
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-2982
Practice Address - Country:US
Practice Address - Phone:248-893-3200
Practice Address - Fax:248-893-2950
Is Sole Proprietor?:No
Enumeration Date:2021-01-13
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5401000415171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist