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General NPI Number Information
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NPI Number | 1881082063
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Entity Type | Organization
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Legal Business Name | ALTERNA WELLNESS CENTER
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Dates
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Enumeration Date | 12/22/2014
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Last Update Date | 12/22/2014
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Provider Practice Location Address
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Address Line | 10803 MAIN ST STE 400
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City | FAIRFAX
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State | VA
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Zip | 22030-4746
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Country | US
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Telephone | 703-915-0118
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Fax | 703-579-4477
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Provider Business Mailing Address
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Address Line | 10803 MAIN ST STE 400
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City | FAIRFAX
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State | VA
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Zip | 22030-4746
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Country | US
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Telephone | 703-915-0118
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Fax | 703-579-4477
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | JI YUN YU
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Credential | PHD, OMD
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Telephone | 703-915-0118
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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 | 0121000526
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License Number State | VA
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