Provider Demographics
NPI:1427317551
Name:LU, FENGQIN
Entity type:Individual
Prefix:MS
First Name:FENGQIN
Middle Name:
Last Name:LU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6638 W OTTAWA AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-4566
Mailing Address - Country:US
Mailing Address - Phone:720-561-9658
Mailing Address - Fax:
Practice Address - Street 1:6638 W OTTAWA AVE STE 210
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80128-4566
Practice Address - Country:US
Practice Address - Phone:720-561-9658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-09
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2504111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA946546OtherAMERICAN SPECIALTY HEALTH MASSAGE THERAPY NETWORK