Healthcare Provider Details

I. General information

NPI: 1952079675
Provider Name (Legal Business Name): WVA ACU HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2021
Last Update Date: 08/30/2021
Certification Date: 08/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 PERRY ST
NEW YORK NY
10014-6241
US

IV. Provider business mailing address

131 PERRY ST
NEW YORK NY
10014-6241
US

V. Phone/Fax

Practice location:
  • Phone: 646-483-9733
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: KIL HWAN KIM
Title or Position: OWNER
Credential: LAC
Phone: 646-483-9733