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General NPI Number Information
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NPI Number | 1356644371
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Entity Type | Individual
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Provider Name | YU YU L.AC.
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Gender | Male
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Dates
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Enumeration Date | 12/14/2010
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Last Update Date | 12/14/2010
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Provider Practice Location Address
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Address Line | 600 CARLISLE DR STE D
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City | HERNDON
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State | VA
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Zip | 20170-4870
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Country | US
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Telephone | 703-628-9138
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Fax |
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Provider Business Mailing Address
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Address Line | 5631 KERTSCHER TER
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City | CENTREVILLE
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State | VA
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Zip | 20120-1982
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Country | US
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Telephone | 703-628-9138
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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 | 0121000363
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License Number State | VA
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