Provider Demographics
NPI:1376681528
Name:HAN, JOHN J K (ACUPUNCTURIST DA)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:J K
Last Name:HAN
Suffix:
Gender:M
Credentials:ACUPUNCTURIST DA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 RESERVOIR AVE
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920
Mailing Address - Country:US
Mailing Address - Phone:401-942-5533
Mailing Address - Fax:401-942-6664
Practice Address - Street 1:1150 RESERVOIR AVE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920
Practice Address - Country:US
Practice Address - Phone:401-942-5533
Practice Address - Fax:401-942-6664
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI1171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist