Provider Demographics
NPI:1306220280
Name:METRO ACUPUNCTURE WELLNESS CLINIC PLLC
Entity Type:Organization
Organization Name:METRO ACUPUNCTURE WELLNESS CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BON YOUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:SUH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-999-8986
Mailing Address - Street 1:1807 PICCARD DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-6067
Mailing Address - Country:US
Mailing Address - Phone:202-999-8986
Mailing Address - Fax:202-318-8918
Practice Address - Street 1:1712 I ST NW
Practice Address - Street 2:SUITE 503
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-3702
Practice Address - Country:US
Practice Address - Phone:202-999-8986
Practice Address - Fax:202-318-8918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-10
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCAC500226171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty