Provider Demographics
NPI:1881162410
Name:ZHANG, HONG (LAC LMT)
Entity type:Individual
Prefix:
First Name:HONG
Middle Name:
Last Name:ZHANG
Suffix:
Gender:F
Credentials:LAC LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 SPAHN DR
Mailing Address - Street 2:
Mailing Address - City:WAUNAKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53597-3011
Mailing Address - Country:US
Mailing Address - Phone:608-960-8512
Mailing Address - Fax:
Practice Address - Street 1:1102 STEPHENSON LN # 100
Practice Address - Street 2:
Practice Address - City:WAUNAKEE
Practice Address - State:WI
Practice Address - Zip Code:53597-2515
Practice Address - Country:US
Practice Address - Phone:608-960-8512
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-13
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14425-146225700000X
WI954-55171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist