Individual
CHENGDE FAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
17 OLD MEADOW RD, WEST HARTFORD, CT 06117-1333
(860) 523-0248
Mailing address
17 OLD MEADOW RD, WEST HARTFORD, CT 06117-1333
(860) 523-0248
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
000182
CT
Other
Enumeration date
03/12/2013
Last updated
03/12/2013
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