Provider Demographics
NPI:1285991505
Name:JIA, JINGWEI (L AC)
Entity type:Individual
Prefix:
First Name:JINGWEI
Middle Name:
Last Name:JIA
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2452 BARRINGTON WAY
Mailing Address - Street 2:UNIT 423
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-7297
Mailing Address - Country:US
Mailing Address - Phone:614-330-8498
Mailing Address - Fax:
Practice Address - Street 1:825 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-3003
Practice Address - Country:US
Practice Address - Phone:419-427-9355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-12
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH65.000156171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist