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General NPI Number Information
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NPI Number | 1376901439
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Entity Type | Organization
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Legal Business Name | ZEN ACUPUNCTURE CLINIC
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Dates
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Enumeration Date | 02/04/2016
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Last Update Date | 02/04/2016
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Provider Practice Location Address
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Address Line | 1542 MCDANIEL DR
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City | WEST CHESTER
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State | PA
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Zip | 19380-7035
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Country | US
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Telephone | 610-430-2131
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Fax |
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Provider Business Mailing Address
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Address Line | 1542 MCDANIEL DR
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City | WEST CHESTER
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State | PA
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Zip | 19380
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Country | US
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Telephone | 610-430-2131
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Fax |
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Authorized Official
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Title or Position | L.AC. DAOM /ONWER
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Name | DONGKYU SONG
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Credential |
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Telephone | 610-430-2131
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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 | OM000100
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License Number State | PA
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