# EAGLE CLASSIC WELLNESS INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** EAGLE CLASSIC WELLNESS INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1437781366
- **Legal business name:** EAGLE CLASSIC WELLNESS INC
- **Authorized official:** DOCK JU CHEONG (PRESIDENT)
- **Authorized official phone:** (909) 229-2721

## Contact information

- **Practice address:** 1914 S WESTERN AVE, LOS ANGELES, CA 90018-1537
- **Practice address phone:** (909) 229-2721
- **Mailing address:** 1914 S WESTERN AVE, LOS ANGELES, CA 90018-1537
- **Mailing address phone:** (909) 229-2721

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | — | NULL | Yes |
| 171100000X | Acupuncturist | — | — | Yes |
| 225200000X | Physical Therapy Assistant | — | NULL | — |
| 225200000X | Physical Therapy Assistant | — | — | — |

## Other

- **Enumeration date:** 02/08/2020
- **Last updated:** 02/08/2020