Provider Demographics
NPI:1306207873
Name:ACUPUNCTURE POINT ORIENTAL MEDICINE, INC
Entity Type:Organization
Organization Name:ACUPUNCTURE POINT ORIENTAL MEDICINE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OF ORIENTAL MEDICINE
Authorized Official - Prefix:DR
Authorized Official - First Name:KHOA
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LAC, DIPL OM
Authorized Official - Phone:252-726-1100
Mailing Address - Street 1:3110 ARENDELL ST
Mailing Address - Street 2:#5
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-6511
Mailing Address - Country:US
Mailing Address - Phone:252-726-1100
Mailing Address - Fax:
Practice Address - Street 1:3110 ARENDELL ST
Practice Address - Street 2:#5
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-6511
Practice Address - Country:US
Practice Address - Phone:252-726-1100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-11
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLAC-884171100000X
NCLAC-881171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty