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General NPI Number Information
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NPI Number | 1588399208
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Entity Type | Organization
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Legal Business Name | GLOW WELLNESS
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Dates
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Enumeration Date | 07/18/2022
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Last Update Date | 07/26/2022
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Provider Practice Location Address
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Address Line | 2100 FOREST AVE STE 101
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City | SAN JOSE
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State | CA
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Zip | 95128-1422
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Country | US
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Telephone | 408-707-4912
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1361
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City | SANTA CLARA
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State | CA
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Zip | 95052-1361
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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 | OWNER
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Name | JUNHWA KIM
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Credential |
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Telephone | 408-707-4912
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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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