MEDICARE: KWANGEUN LEE L.AC.

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	0121001235	VA

General Provider Information

NPI Number	:	1871451708
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KWANGEUN LEE L.AC.

Provider Business Mailing Address
First Line	:	1980 GALLOWS RD
Second Line	:
City	:	VIENNA
State	:	VA
Zip	:	22182-3913
Country	:	US
Telephone Number	:	703-323-5691
Fax Number	:

Provider Business Practice Location Address
First Line	:	1980 GALLOWS RD
Second Line	:
City	:	VIENNA
State	:	VA
Zip	:	22182-3913
Country	:	US
Telephone Number	:	703-323-5691
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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Directions to “ KWANGEUN LEE L.AC.” Practice Location

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