MEDICARE: PROCARE ACUPUNCTURE AND WELLNESS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist
2	261Q00000X	Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1457149940	OTHER	VA	ACUPUNCTURE
2	1477219616	OTHER	VA	ACUPUNCTURE

General Provider Information

NPI Number	:	1770374290
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROCARE ACUPUNCTURE AND WELLNESS

Provider Business Mailing Address
First Line	:	7349 RHONDDA DR
Second Line	:
City	:	LORTON
State	:	VA
Zip	:	22079-1570
Country	:	US
Telephone Number	:	813-260-6263
Fax Number	:

Provider Business Practice Location Address
First Line	:	3007 WILLIAMS DR
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22031-4612
Country	:	US
Telephone Number	:	571-207-6789
Fax Number	:

Authorized Official
Title or Position	:	ACUPUNCTURIST
Name	:	PUKAI JIN
Credential	:	DOM
Telephone Number	:	571-207-6789

Provider Enumeration Date	:	05/14/2025
Last Update Date	:	05/17/2025

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Directions to “PROCARE ACUPUNCTURE AND WELLNESS ” Practice Location

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