Organization
ACUPUNCTURE MEDICAL PRACTICE
Active
Other names
Green Healing Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. QINGYAO SHI DOM (ACUPUNCTURIST)
(215) 751-9833
Entity
Organization
Contact information
Practice address
1737 CHESTNUT ST STE 200, PHILADELPHIA, PA 19103-4108
(215) 751-9833
(215) 575-0454
Mailing address
1737 CHESTNUT ST STE 200, PHILADELPHIA, PA 19103-4108
(215) 751-9833
(215) 575-0454
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
OM000033
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
191626032
ACUPUNCTURIST
PA
Enumeration date
01/21/2016
Last updated
01/21/2016
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