Provider Demographics
NPI:1710702659
Name:LIN, MIAOYI (LAC)
Entity type:Individual
Prefix:
First Name:MIAOYI
Middle Name:
Last Name:LIN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1769 JAMESTOWN RD STE 211
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-2386
Mailing Address - Country:US
Mailing Address - Phone:919-358-5506
Mailing Address - Fax:
Practice Address - Street 1:1769 JAMESTOWN RD STE 211
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-2386
Practice Address - Country:US
Practice Address - Phone:919-358-5506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-16
Last Update Date:2024-11-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0121001097171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist