Provider Demographics
NPI:1578867578
Name:JUN, HYUNG WOOK (LAC,PHD)
Entity Type:Individual
Prefix:
First Name:HYUNG WOOK
Middle Name:
Last Name:JUN
Suffix:
Gender:M
Credentials:LAC,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10194 BALTIMORE NATIONAL PIKE
Mailing Address - Street 2:#108
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-3653
Mailing Address - Country:US
Mailing Address - Phone:410-465-9077
Mailing Address - Fax:
Practice Address - Street 1:10194 BALTIMORE NATIONAL PIKE
Practice Address - Street 2:#108
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-3653
Practice Address - Country:US
Practice Address - Phone:410-465-9077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-05
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU00972171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist