Healthcare Provider Details

I. General information

NPI: 1780920595
Provider Name (Legal Business Name): DANNY TU KHOUNH LOM, L.AC, DAOM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/26/2012
Last Update Date: 12/02/2023
Certification Date: 12/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

258 S STATE ST STE 2
NEWTOWN PA
18940-3527
US

IV. Provider business mailing address

1220 LINDEN AVE
YARDLEY PA
19067-7416
US

V. Phone/Fax

Practice location:
  • Phone: 215-322-6035
  • Fax: 267-797-5100
Mailing address:
  • Phone: 215-322-6035
  • Fax: 267-797-5100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberOM000162
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: