# HOLYSTICK,LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** HolyStick,LLC, Medical Facility, Acupuncture, Ki-Bone
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619506300
- **Authorized official:** HANUL JUNG DOA (CEO)
- **Authorized official phone:** (240) 945-8525

## Contact information

- **Practice address:** 8550 ROUTE 29 STE 720, FAIRFAX, VA 22031-1531
- **Practice address phone:** (703) 981-5085
- **Practice address fax:** (240) 901-4515
- **Mailing address:** 14428 HOMECREST RD, SILVER SPRING, MD 20906-1820
- **Mailing address phone:** (240) 506-6549
- **Mailing address fax:** (240) 901-4515

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2000X | Physical Therapy Clinic/Center | — | — | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 04/03/2020
- **Last updated:** 01/18/2026