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General NPI Number Information
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NPI Number | 1538938477
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Entity Type | Organization
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Legal Business Name | LU ACUPUNCTURE & HERB CLINIC LLC
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Dates
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Enumeration Date | 12/20/2023
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Last Update Date | 12/20/2023
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Provider Practice Location Address
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Address Line | 211 PROME POINT, BLDG 2 STE F
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City | PEACHTREE CITY
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State | GA
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Zip | 30269
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Country | US
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Telephone | 770-268-1801
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Fax | 470-407-6985
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Provider Business Mailing Address
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Address Line | 211 PROME POINT, BLDG 2 STE F
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City | PEACHTREE CITY
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State | GA
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Zip | 30269
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Country | US
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Telephone | 770-268-1801
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Fax | 470-407-6985
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Authorized Official
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Title or Position | OWNER/HEALTH CARE PROVIDER
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Name | MRS. LU H PHOUN
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Credential | L.A.C ACUPUNCTURIST
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Telephone | 770-268-1801
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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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