Provider Demographics
NPI:1649802950
Name:OH, PILHOON
Entity type:Individual
Prefix:
First Name:PILHOON
Middle Name:
Last Name:OH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7004 LITTLE RIVER TPKE STE B
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-3201
Mailing Address - Country:US
Mailing Address - Phone:703-489-0448
Mailing Address - Fax:
Practice Address - Street 1:7004 LITTLE RIVER TPKE STE B
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3201
Practice Address - Country:US
Practice Address - Phone:703-489-0448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019015450225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist