Provider Demographics
NPI:1902336407
Name:GUO, HUA (LAC)
Entity Type:Individual
Prefix:MR
First Name:HUA
Middle Name:
Last Name:GUO
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 1:5000 S MAC ARTHUR LN APT 206
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-5429
Mailing Address - Country:US
Mailing Address - Phone:512-217-9217
Mailing Address - Fax:
Practice Address - Street 1:5132 S CLIFF AVE STE 3
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-5434
Practice Address - Country:US
Practice Address - Phone:605-691-4279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-16
Last Update Date:2017-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE60171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist