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General NPI Number Information
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NPI Number | 1477341154
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Entity Type | Organization
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Legal Business Name | CORE INTEGRATIVE CARE & WELLNESS, INC.
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Dates
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Enumeration Date | 04/30/2025
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 14153 ROBERT PARIS CT STE A
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City | CHANTILLY
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State | VA
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Zip | 20151-4225
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Country | US
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Telephone | 703-865-6455
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Fax | 36-496-4557
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Provider Business Mailing Address
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Address Line | 14153 ROBERT PARIS CT STE A
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City | CHANTILLY
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State | VA
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Zip | 20151-4225
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Country | US
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Telephone | 703-865-6455
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Fax | 703-649-6455
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRIAN WOOGI KIM
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Credential | DPT
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Telephone | 703-865-6455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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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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