Provider Demographics
NPI:1104146182
Name:CHEN, WEN-WEN (LAC)
Entity type:Individual
Prefix:MS
First Name:WEN-WEN
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:747 TIMBER CREEK DR
Mailing Address - Street 2:SUIT 9
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-6375
Mailing Address - Country:US
Mailing Address - Phone:901-240-1383
Mailing Address - Fax:
Practice Address - Street 1:2171 JUDICIAL DR STE 100
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-3800
Practice Address - Country:US
Practice Address - Phone:901-427-8048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-02
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNACU0000000148171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist