Provider Demographics
NPI:1184911109
Name:ZHANG, QINGGEN (LAC)
Entity type:Individual
Prefix:
First Name:QINGGEN
Middle Name:
Last Name:ZHANG
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 HUBER PARK CT
Mailing Address - Street 2:
Mailing Address - City:WELDON SPRING
Mailing Address - State:MO
Mailing Address - Zip Code:63304-8621
Mailing Address - Country:US
Mailing Address - Phone:636-675-9688
Mailing Address - Fax:636-329-8977
Practice Address - Street 1:520 HUBER PARK CT
Practice Address - Street 2:
Practice Address - City:WELDON SPRING
Practice Address - State:MO
Practice Address - Zip Code:63304-8621
Practice Address - Country:US
Practice Address - Phone:636-675-9688
Practice Address - Fax:636-329-8977
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-29
Last Update Date:2011-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007035068171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist