Provider Demographics
NPI:1386786259
Name:INTEGRA ACUPUNCTURE ASSOCIATES, INC.
Entity type:Organization
Organization Name:INTEGRA ACUPUNCTURE ASSOCIATES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NING
Authorized Official - Middle Name:
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD (CHINA), RAC
Authorized Official - Phone:614-530-0588
Mailing Address - Street 1:750 CROSS POINTE RD STE H
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43230-6692
Mailing Address - Country:US
Mailing Address - Phone:614-530-0588
Mailing Address - Fax:614-626-3268
Practice Address - Street 1:750 CROSS POINTE RD STE H
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43230-6692
Practice Address - Country:US
Practice Address - Phone:614-530-0588
Practice Address - Fax:614-626-3268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH65.000056171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty