Provider Demographics
NPI:1164087045
Name:NARA PHYSICAL THERAPY CHIROPRACTIC & ACUPUNCTURE PLLC
Entity Type:Organization
Organization Name:NARA PHYSICAL THERAPY CHIROPRACTIC & ACUPUNCTURE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KWANGCHUL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:718-445-6272
Mailing Address - Street 1:16410 CROCHERON AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-2016
Mailing Address - Country:US
Mailing Address - Phone:718-445-6272
Mailing Address - Fax:718-445-6274
Practice Address - Street 1:16410 CROCHERON AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-2016
Practice Address - Country:US
Practice Address - Phone:718-445-6272
Practice Address - Fax:718-445-6274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-06
Last Update Date:2019-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty