Provider Demographics
NPI:1437636388
Name:PAUL ACUPUNCTURE AND WELLNESS
Entity Type:Organization
Organization Name:PAUL ACUPUNCTURE AND WELLNESS
Other - Org Name:PAUL ACUPUNCTURE AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HYUNG SIK
Authorized Official - Middle Name:
Authorized Official - Last Name:BYEON
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:703-300-7951
Mailing Address - Street 1:4127 RIVER FORTH DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-8570
Mailing Address - Country:US
Mailing Address - Phone:703-300-7951
Mailing Address - Fax:
Practice Address - Street 1:7004 LITTLE RIVER TPKE # 2F
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-5965
Practice Address - Country:US
Practice Address - Phone:703-354-0494
Practice Address - Fax:703-354-0609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-24
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000741171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty