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General NPI Number Information
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NPI Number | 1831472059
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Entity Type | Individual
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Provider Name | JIHUN KWAK DPT, MSA, L.AC.
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Gender | Male
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Dates
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Enumeration Date | 09/23/2011
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 7010 LITTLE RIVER TPKE STE 335
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City | ANNANDALE
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State | VA
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Zip | 22003-3249
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Country | US
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Telephone | 703-827-3488
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Fax | 571-526-5522
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Provider Business Mailing Address
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Address Line | 7010 LITTLE RIVER TPKE STE 335
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City | ANNANDALE
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State | VA
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Zip | 22003-3249
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Country | US
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Telephone | 703-827-3488
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Fax | 571-526-5522
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 0121001202
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305207264
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License Number State | VA
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