Provider Demographics
NPI:1982161063
Name:LEU, HSIUNG C
Entity Type:Individual
Prefix:
First Name:HSIUNG
Middle Name:C
Last Name:LEU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:HSIUNG
Other - Middle Name:CHING
Other - Last Name:LEU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT, LAC
Mailing Address - Street 1:112 W SPRINGBROOK DR
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-1757
Mailing Address - Country:US
Mailing Address - Phone:201-245-3703
Mailing Address - Fax:
Practice Address - Street 1:112 W SPRINGBROOK DR
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-1757
Practice Address - Country:US
Practice Address - Phone:201-245-3703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-26
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14871225700000X
TN402171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist