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General NPI Number Information
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NPI Number | 1366245086
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Entity Type | Organization
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Legal Business Name | SERENITY ACUPUNCTURE AND HEALING LLC
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Dates
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Enumeration Date | 03/28/2025
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Last Update Date | 03/28/2025
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Provider Practice Location Address
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Address Line | 1035 STERLING RD STE 101
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City | HERNDON
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State | VA
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Zip | 20170-3838
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Country | US
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Telephone | 703-593-6501
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Fax |
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Provider Business Mailing Address
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Address Line | 12805 NETHERLEIGH PL
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City | HERNDON
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State | VA
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Zip | 20171-4222
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Country | US
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Telephone | 703-955-7698
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Fax |
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Authorized Official
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Title or Position | LICENSED ACUPUNCTURE
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Name | LAN GAO
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Credential | LAN GAO
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Telephone | 703-593-6501
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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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