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General NPI Number Information
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NPI Number | 1083332530
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Entity Type | Organization
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Legal Business Name | MOON HEALING ACUPUNCTURE & INTEGRATIVE HEALTH LLC
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Dates
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Enumeration Date | 08/19/2022
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Last Update Date | 08/19/2022
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Provider Practice Location Address
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Address Line | 11269 OLD FREDERICK RD
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City | MARRIOTTSVILLE
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State | MD
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Zip | 21104-1518
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Country | US
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Telephone | 240-416-0612
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Fax |
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Provider Business Mailing Address
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Address Line | 11269 OLD FREDERICK RD
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City | MARRIOTTSVILLE
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State | MD
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Zip | 21104-1518
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Country | US
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Telephone | 240-416-0612
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MOON H PARK
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Credential | ACU
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Telephone | 240-416-0612
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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 |
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License Number State |
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