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General NPI Number Information
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NPI Number | 1306729645
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Entity Type | Organization
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Legal Business Name | THREE RIVERS ACUPUNCTURE & HERB LLC
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Dates
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Enumeration Date | 07/25/2025
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 304 W MONDAMIN ST STE 116
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City | MINOOKA
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State | IL
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Zip | 60447-4618
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Country | US
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Telephone | 815-242-2558
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Fax |
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Provider Business Mailing Address
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Address Line | 26055 W RAVINE WOODS DR
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City | CHANNAHON
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State | IL
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Zip | 60410-3428
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LINGMAN SUN
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Credential |
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Telephone | 757-585-0391
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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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