Organization
AOM CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAE Y RIM DAOM, L.AC. (PRESIDENT AND CLINIC DIRECTOR)
(571) 287-1764
Entity
Organization
Contact information
Practice address
7535 LITTLE RIVER TPKE STE 103A, ANNANDALE, VA 22003-2983
(571) 287-1764
(888) 276-6354
Mailing address
7535 LITTLE RIVER TPKE STE 103A, ANNANDALE, VA 22003-2983
(571) 287-1764
(888) 276-6354
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
—
225700000X
Massage Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0121000474
STATE ACUPUNCTURE LICENSE
VA
01
—
0121000929
STATE ACUPUNCTURE LICENSE
VA
01
—
19009773
STATE MASSAGE LICENSE
VA
01
—
AC500174
STATE ACUPUNCTURE LICENSE
DC
Enumeration date
12/11/2019
Last updated
12/11/2019
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