Basic Information
Provider Information
NPI: 1245760321
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZHOU
FirstName: YUXIN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
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OtherLastName:  
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Mailing Information
Address1: 966A KILLIAN HILL RD SW
Address2:  
City: LILBURN
State: GA
PostalCode: 300473102
CountryCode: US
TelephoneNumber: 7709234815
FaxNumber: 7709230901
Practice Location
Address1: 966A KILLIAN HILL RD SW
Address2:  
City: LILBURN
State: GA
PostalCode: 300473102
CountryCode: US
TelephoneNumber: 7709234815
FaxNumber: 7709230901
Other Information
ProviderEnumerationDate: 06/12/2017
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT012922GAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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