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Individual

KENICHI NISHIYA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
L.AC

Contact information

Practice address
1915 S AUSTIN AVE, SUITE 102, GEORGETOWN, TX 78626-7843
(512) 868-9109
Mailing address
1915 S AUSTIN AVE, SUITE 102, GEORGETOWN, TX 78626-7843
(512) 868-9109

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC00922
TX

Other

Enumeration date
09/17/2009
Last updated
09/17/2009
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