Provider Demographics
NPI:1144603036
Name:ACUPUNCTURE INNAECHUN,INC
Entity Type:Organization
Organization Name:ACUPUNCTURE INNAECHUN,INC
Other - Org Name:ACUPUNCTURE INNAECHUN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:PROF
Authorized Official - First Name:JE
Authorized Official - Middle Name:U
Authorized Official - Last Name:YOO
Authorized Official - Suffix:
Authorized Official - Credentials:LI,AC
Authorized Official - Phone:703-642-3300
Mailing Address - Street 1:4208 EVERGREEN LN
Mailing Address - Street 2:SUITE 224
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-3235
Mailing Address - Country:US
Mailing Address - Phone:703-642-3300
Mailing Address - Fax:
Practice Address - Street 1:4208 EVERGREEN LN
Practice Address - Street 2:SUITE 224
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3235
Practice Address - Country:US
Practice Address - Phone:703-642-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACUPUNCTURE INNAECHUN, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-09
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000519171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty