Provider Demographics
NPI:1275582462
Name:AHN, SEONG (LAC)
Entity Type:Individual
Prefix:MS
First Name:SEONG
Middle Name:
Last Name:AHN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:MS
Other - First Name:CINDY
Other - Middle Name:
Other - Last Name:AHN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:2875 TROY CENTER DR
Mailing Address - Street 2:APT. 5020
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-4718
Mailing Address - Country:US
Mailing Address - Phone:248-561-1213
Mailing Address - Fax:
Practice Address - Street 1:47100 SCHOENHERR RD
Practice Address - Street 2:SUITE E
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48315-4716
Practice Address - Country:US
Practice Address - Phone:586-685-0505
Practice Address - Fax:586-685-0501
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist