Provider Demographics
NPI:1528424207
Name:WANG, BIN
Entity type:Individual
Prefix:
First Name:BIN
Middle Name:
Last Name:WANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 BEAL PKWY NE
Mailing Address - Street 2:
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32548-4819
Mailing Address - Country:US
Mailing Address - Phone:850-864-1688
Mailing Address - Fax:850-999-7585
Practice Address - Street 1:51 BEAL PKWY NE
Practice Address - Street 2:
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32548-4819
Practice Address - Country:US
Practice Address - Phone:850-864-1688
Practice Address - Fax:850-999-7585
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-11
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2937171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist