Provider Demographics
NPI:1396076014
Name:QIAO, YUSHENG (L AC)
Entity type:Individual
Prefix:
First Name:YUSHENG
Middle Name:
Last Name:QIAO
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:11240 ABBOTTS STATION DR
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-5717
Mailing Address - Country:US
Mailing Address - Phone:404-402-9007
Mailing Address - Fax:678-374-1963
Practice Address - Street 1:5677 BUFORD HWY NE
Practice Address - Street 2:SUITE 210
Practice Address - City:DORAVILLE
Practice Address - State:GA
Practice Address - Zip Code:30340-1244
Practice Address - Country:US
Practice Address - Phone:404-402-9007
Practice Address - Fax:678-374-1963
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA14171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist