Provider Demographics
NPI:1598366411
Name:JUNG TAO SCHOOL OF CLASSICAL CHINESE MEDICINE
Entity Type:Organization
Organization Name:JUNG TAO SCHOOL OF CLASSICAL CHINESE MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:BRYSON
Authorized Official - Suffix:
Authorized Official - Credentials:CMT, LAC
Authorized Official - Phone:828-297-4161
Mailing Address - Street 1:207 DALE ADAMS RD
Mailing Address - Street 2:
Mailing Address - City:SUGAR GROVE
Mailing Address - State:NC
Mailing Address - Zip Code:28679-9657
Mailing Address - Country:US
Mailing Address - Phone:828-297-4161
Mailing Address - Fax:828-297-4171
Practice Address - Street 1:207 DALE ADAMS RD
Practice Address - Street 2:
Practice Address - City:SUGAR GROVE
Practice Address - State:NC
Practice Address - Zip Code:28679-9657
Practice Address - Country:US
Practice Address - Phone:828-297-4161
Practice Address - Fax:828-297-4171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty