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General NPI Number Information
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NPI Number | 1992998140
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Entity Type | Individual
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Provider Name | LONG HUYNH L.AC , MSOM
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Gender | Male
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Dates
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Enumeration Date | 08/21/2007
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Last Update Date | 06/23/2020
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Provider Practice Location Address
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Address Line | 239 W CERMAK RD
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City | CHICAGO
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State | IL
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Zip | 60616-1913
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Country | US
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Telephone | 312-889-1239
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Fax | 312-225-0994
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Provider Business Mailing Address
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Address Line | 239 W CERMAK RD
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City | CHICAGO
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State | IL
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Zip | 60616-1913
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Country | US
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Telephone | 312-420-3050
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Fax |
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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 | 198.000697
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License Number State | IL
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