Provider Demographics
NPI:1386027035
Name:CHINESE MASSAGE & ACUPRESSURE
Entity type:Organization
Organization Name:CHINESE MASSAGE & ACUPRESSURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPY AND ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:YAN
Authorized Official - Middle Name:NIAN
Authorized Official - Last Name:FAN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:804-937-6738
Mailing Address - Street 1:9419 BROAD MEADOWS RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-3101
Mailing Address - Country:US
Mailing Address - Phone:804-937-6738
Mailing Address - Fax:
Practice Address - Street 1:3601 MAYLAND CT
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23233-1409
Practice Address - Country:US
Practice Address - Phone:804-937-6738
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-30
Last Update Date:2017-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000655171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty