Provider Demographics
NPI:1487996948
Name:JIANG, CHARLENE XIAOLIN
Entity type:Individual
Prefix:
First Name:CHARLENE
Middle Name:XIAOLIN
Last Name:JIANG
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 1:5920 CLEVELAND AVE
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49127-9482
Mailing Address - Country:US
Mailing Address - Phone:269-429-5189
Mailing Address - Fax:269-429-5204
Practice Address - Street 1:5920 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:STEVENSVILLE
Practice Address - State:MI
Practice Address - Zip Code:49127-9482
Practice Address - Country:US
Practice Address - Phone:269-429-5189
Practice Address - Fax:269-429-5204
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-22
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist