Provider Demographics
NPI:1497996458
Name:ACUPUNCTURE & HERB CLINIC, LLC
Entity Type:Organization
Organization Name:ACUPUNCTURE & HERB CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TUAN
Authorized Official - Middle Name:ANH
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LAC
Authorized Official - Phone:703-430-7058
Mailing Address - Street 1:21351 GENTRY DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-8501
Mailing Address - Country:US
Mailing Address - Phone:703-430-7058
Mailing Address - Fax:703-562-7030
Practice Address - Street 1:19420 GOLF VISTA PLZ
Practice Address - Street 2:SUITE 230
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-8265
Practice Address - Country:US
Practice Address - Phone:703-297-5993
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-20
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000487171100000X
MDU01126171100000X
VA0121000424171100000X
MD000825171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty