Provider Demographics
NPI:1992826044
Name:WHANG, KYUNG-HA (LIC AC)
Entity Type:Individual
Prefix:
First Name:KYUNG-HA
Middle Name:
Last Name:WHANG
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 N MAIN ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:MANSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02048-3803
Mailing Address - Country:US
Mailing Address - Phone:508-337-3087
Mailing Address - Fax:
Practice Address - Street 1:129 N MAIN ST
Practice Address - Street 2:SUITE 204
Practice Address - City:MANSFIELD
Practice Address - State:MA
Practice Address - Zip Code:02048-3803
Practice Address - Country:US
Practice Address - Phone:508-337-3087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA203207171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist