Provider Demographics
NPI:1649718537
Name:VU, THI ANH (LAC)
Entity type:Individual
Prefix:
First Name:THI
Middle Name:ANH
Last Name:VU
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4525 FILLINGAME DR
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20151-2820
Mailing Address - Country:US
Mailing Address - Phone:415-864-9220
Mailing Address - Fax:
Practice Address - Street 1:3085 NUTLEY ST
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-1931
Practice Address - Country:US
Practice Address - Phone:703-281-7771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-10
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000827171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist