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General NPI Number Information
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NPI Number | 1417032103
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Entity Type | Organization
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Legal Business Name | HOLISTIC ACUPUNCTURE AND PHYSICAL THERAPY CENTER, LLC
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 03/01/2017
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Provider Practice Location Address
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Address Line | 957 RUSSELL AVE SUITE B
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City | GAITHERSBURG
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State | MD
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Zip | 20879-6215
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Country | US
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Telephone | 301-987-0596
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Fax | 301-987-0398
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Provider Business Mailing Address
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Address Line | 957 RUSSELL AVE SUITE B
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City | GAITHERSBURG
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State | MD
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Zip | 20879-6215
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Country | US
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Telephone | 301-987-0596
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Fax | 301-987-0398
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Authorized Official
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Title or Position | OWNER
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Name | SOPHIE X DENG
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Credential | P.T., L.AC.
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Telephone | 301-987-0596
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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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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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