Koa, Fannie Tan
Koa, Fannie Tan is an sole proprietor health care provider with primary practice located at 259 Elm St Suite 300B, Somerville MA 02144-2950. She recently has only one registered license in Other Service Providers / Acupuncturist, which is considered as her primary health care specialty. Koa, Fannie Tan can be contacted via phone (617) 294-9109.Contact Information
Primary practice address
259 Elm St Suite 300B
Somerville MA 02144-2950
Phone: (617) 294-9109
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Acupuncturist | 171100000X | 253925 | Massachusetts |
| Other Service Providers / Acupuncturist | 171100000X | 205 | New Hampshire |
Profile Details
| NPI number | 1588925077 |
|---|---|
| LBN Legal business name | Koa, Fannie Tan |
| Credentials | LIC.AC., DIPL.OM |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 31st, 2012 |
| Last updated | Feb 15th, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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