Healthcare Provider Details

I. General information

NPI: 1689590168
Provider Name (Legal Business Name): MS. KYUNG RIM R JUNG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9032 FALLS CHAPEL WAY
POTOMAC MD
20854-2388
US

IV. Provider business mailing address

9032 FALLS CHAPEL WAY
POTOMAC MD
20854-2388
US

V. Phone/Fax

Practice location:
  • Phone: 202-870-6773
  • Fax:
Mailing address:
  • Phone: 202-870-6773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberU03348
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: