MEDICARE: YOUNG JAI CHANG L.AC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	0121000553	VA

General Provider Information

NPI Number	:	1255651238
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOUNG JAI CHANG L.AC

Provider Business Mailing Address
First Line	:	7006 LITTLE RIVER TPKE
Second Line	:	STE D
City	:	ANNANDALE
State	:	VA
Zip	:	22003-3218
Country	:	US
Telephone Number	:	703-642-5488
Fax Number	:	703-642-5489

Provider Business Practice Location Address
First Line	:	7006 LITTLE RIVER TPKE
Second Line	:	STE D
City	:	ANNANDALE
State	:	VA
Zip	:	22003-3218
Country	:	US
Telephone Number	:	703-642-5488
Fax Number	:	703-642-5489

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2010
Last Update Date	:	06/01/2010

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Directions to “ YOUNG JAI CHANG L.AC” Practice Location

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