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General NPI Number Information
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NPI Number | 1508544651
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Entity Type | Organization
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Legal Business Name | ROOT & BALANCE ACUPUNCTURE LLC
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Dates
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Enumeration Date | 07/10/2023
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Last Update Date | 07/10/2023
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Provider Practice Location Address
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Address Line | 103 ROWELL CT
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City | FALLS CHURCH
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State | VA
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Zip | 22046-3126
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Country | US
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Telephone | 571-766-8188
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Fax |
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Provider Business Mailing Address
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Address Line | 1646 KURPIERS CT
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City | MC LEAN
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State | VA
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Zip | 22101-5017
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | JUDITH ALLEN
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Credential | MS, DIPL.AC., L.AC.
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Telephone | 703-577-8386
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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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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