Provider Demographics
NPI:1811064546
Name:HOU, GUAN R (LIC AC)
Entity type:Individual
Prefix:
First Name:GUAN
Middle Name:R
Last Name:HOU
Suffix:
Gender:M
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:55 PARK ST
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-6325
Mailing Address - Country:US
Mailing Address - Phone:617-975-3813
Mailing Address - Fax:
Practice Address - Street 1:1419 BEACON ST
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-4808
Practice Address - Country:US
Practice Address - Phone:617-975-3813
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA559171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist