Provider Demographics
NPI:1841360732
Name:LI, LILY LI (ACUPUNCTURIST)
Entity type:Individual
Prefix:MS
First Name:LILY
Middle Name:LI
Last Name:LI
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3325 CHAMBLEE DUNWOODY RD
Mailing Address - Street 2:
Mailing Address - City:CHAMBLEE
Mailing Address - State:GA
Mailing Address - Zip Code:30341-2816
Mailing Address - Country:US
Mailing Address - Phone:770-451-6841
Mailing Address - Fax:
Practice Address - Street 1:3325 CHAMBLEE DUNWOODY RD
Practice Address - Street 2:
Practice Address - City:CHAMBLEE
Practice Address - State:GA
Practice Address - Zip Code:30341-2816
Practice Address - Country:US
Practice Address - Phone:770-451-6841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA36171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist