Provider Demographics
NPI:1558809582
Name:YOUNG YANG ACUPUNCTURE CLINIC
Entity Type:Organization
Organization Name:YOUNG YANG ACUPUNCTURE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YOUNG
Authorized Official - Middle Name:JUN
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-647-0524
Mailing Address - Street 1:9192 RED BRANCH RD
Mailing Address - Street 2:#140
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-2030
Mailing Address - Country:US
Mailing Address - Phone:703-647-0524
Mailing Address - Fax:443-545-5307
Practice Address - Street 1:9192 RED BRANCH RD
Practice Address - Street 2:#140
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2030
Practice Address - Country:US
Practice Address - Phone:703-647-0524
Practice Address - Fax:443-545-5307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-09
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02339171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty