Healthcare Provider Details

I. General information

NPI: 1578488722
Provider Name (Legal Business Name): SPRINGWILL INTEGRATIVE HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

463 CARLISLE DR STE B
HERNDON VA
20170-5609
US

IV. Provider business mailing address

1500 LINCOLN CIR APT 206
MC LEAN VA
22102-5864
US

V. Phone/Fax

Practice location:
  • Phone: 703-495-2857
  • 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: RAN TAO
Title or Position: OWNER
Credential:
Phone: 214-608-7013