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General NPI Number Information
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NPI Number | 1053057836
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Entity Type | Individual
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Provider Name | MR. JOHAN K AHN JR.
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Gender | Male
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Dates
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Enumeration Date | 05/05/2022
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Last Update Date | 05/05/2022
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Provider Practice Location Address
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Address Line | 1645 CONNECTICUT AVE NW APT 3
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City | WASHINGTON
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State | DC
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Zip | 20009-1054
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Country | US
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Telephone | 202-297-7404
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Fax |
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Provider Business Mailing Address
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Address Line | 7008 BALMORAL FOREST RD
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City | CLIFTON
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State | VA
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Zip | 20124-1538
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Country | US
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Telephone | 425-505-1307
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 0121001049
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License Number State | VA
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