Provider Demographics
NPI:1205694767
Name:THERAPEUTIC ACUPUNCTURE AND HERBAL MEDICINE LLC
Entity type:Organization
Organization Name:THERAPEUTIC ACUPUNCTURE AND HERBAL MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST/
Authorized Official - Prefix:
Authorized Official - First Name:YILAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FANG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:347-338-9252
Mailing Address - Street 1:3126 HARRISON HOLLOW LN
Mailing Address - Street 2:
Mailing Address - City:OAK HILL
Mailing Address - State:VA
Mailing Address - Zip Code:20171-2330
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14631 ROUTE 29 STE 115
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20121-5825
Practice Address - Country:US
Practice Address - Phone:703-825-7130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty