Healthcare Provider Details

I. General information

NPI: 1720803265
Provider Name (Legal Business Name): EXEEDA WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2024
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7700 LITTLE RIVER TPKE # 104
ANNANDALE VA
22003-2427
US

IV. Provider business mailing address

7700 LITTLE RIVER TPKE # 104
ANNANDALE VA
22003-2427
US

V. Phone/Fax

Practice location:
  • Phone: 703-401-7171
  • Fax:
Mailing address:
  • Phone: 703-401-7171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: JUNHO YOON
Title or Position: ACUPUNCTURIST
Credential:
Phone: 703-401-7171