Provider Demographics
NPI:1053781963
Name:LIU, XIAOYAN (PHD, DIPL AC)
Entity type:Individual
Prefix:DR
First Name:XIAOYAN
Middle Name:
Last Name:LIU
Suffix:
Gender:F
Credentials:PHD, DIPL AC
Other - Prefix:DR
Other - First Name:XIAO YAN
Other - Middle Name:
Other - Last Name:LIU
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD, DIPL AC
Mailing Address - Street 1:355 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-2325
Mailing Address - Country:US
Mailing Address - Phone:715-497-4817
Mailing Address - Fax:
Practice Address - Street 1:355 GRAND AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2325
Practice Address - Country:US
Practice Address - Phone:715-497-4817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-05
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1566171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist