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General NPI Number Information
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NPI Number | 1578264511
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Entity Type | Organization
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Legal Business Name | HEALING ACUPUNCTURE & CHINESE HERBAL MEDICINE LLC
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Dates
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Enumeration Date | 03/16/2023
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Last Update Date | 03/17/2023
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Provider Practice Location Address
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Address Line | 4816 SIX FORKS RD STE 102
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City | RALEIGH
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State | NC
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Zip | 27609-5250
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Country | US
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Telephone | 919-803-2424
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Fax | 919-803-2193
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Provider Business Mailing Address
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Address Line | 4816 SIX FORKS RD STE 102
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City | RALEIGH
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State | NC
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Zip | 27609-5250
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Country | US
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Telephone | 919-803-2424
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Fax | 919-803-2193
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Authorized Official
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Title or Position | ACUPUNCTURIST/OWNER
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Name | DOUG C KO
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Credential | LAC
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Telephone | 919-803-2424
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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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