Provider Demographics
NPI:1912189234
Name:ORIENTAL ACU HERB LLC
Entity Type:Organization
Organization Name:ORIENTAL ACU HERB LLC
Other - Org Name:ORIENTAL ACU HERB NATURE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER & PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:JIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUO
Authorized Official - Suffix:
Authorized Official - Credentials:DOM, LAC
Authorized Official - Phone:610-628-9220
Mailing Address - Street 1:4990 STATE RD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-4635
Mailing Address - Country:US
Mailing Address - Phone:610-628-9220
Mailing Address - Fax:610-628-9214
Practice Address - Street 1:4990 STATE RD
Practice Address - Street 2:SUITE 7
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-4635
Practice Address - Country:US
Practice Address - Phone:610-628-9220
Practice Address - Fax:610-628-9214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAKO000598171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty