Provider Demographics
NPI:1356850382
Name:RIO ACUPUNCTURE INC
Entity Type:Organization
Organization Name:RIO ACUPUNCTURE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:TAESUN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:DOM
Authorized Official - Phone:770-451-7848
Mailing Address - Street 1:5441 BUFORD HWY NE STE 202
Mailing Address - Street 2:
Mailing Address - City:DORAVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30340-1168
Mailing Address - Country:US
Mailing Address - Phone:770-451-7848
Mailing Address - Fax:
Practice Address - Street 1:5441 BUFORD HWY NE STE 202
Practice Address - Street 2:
Practice Address - City:DORAVILLE
Practice Address - State:GA
Practice Address - Zip Code:30340-1168
Practice Address - Country:US
Practice Address - Phone:770-451-7848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA125171100000X
GA338171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty