Provider Demographics
NPI:1295071561
Name:ESSENCE OF ACUPUNCTURE LLC
Entity type:Organization
Organization Name:ESSENCE OF ACUPUNCTURE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:I-HSIN
Authorized Official - Middle Name:TAMMY
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:LIC AC
Authorized Official - Phone:571-426-2195
Mailing Address - Street 1:2273 KINGS GARDEN WAY
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22043
Mailing Address - Country:US
Mailing Address - Phone:571-426-2195
Mailing Address - Fax:703-821-1264
Practice Address - Street 1:2273 KINGS GARDEN WAY
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22043
Practice Address - Country:US
Practice Address - Phone:571-426-2195
Practice Address - Fax:703-821-1264
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-14
Last Update Date:2012-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01968171100000X
VA0121000675171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty