MEDICARE: EMILY 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	0121000650	VA
2	171100000X	Acupuncturist	U01904	MD

General Provider Information

NPI Number	:	1629412887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY CHANG L.AC

Provider Business Mailing Address
First Line	:	9742 VALE RD NW
Second Line	:
City	:	VIENNA
State	:	VA
Zip	:	22181-5464
Country	:	US
Telephone Number	:	571-318-7151
Fax Number	:

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

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

Provider Enumeration Date	:	04/18/2013
Last Update Date	:	04/18/2013

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Directions to “ EMILY CHANG L.AC” Practice Location

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