Organization
NOURISH ACUCLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LONG NGOC HUYNH LAC (CHIEF EXECUTIVE OFFICER)
(312) 420-3050
Entity
Organization
Contact information
Practice address
2545 S HILLOCK AVE, CHICAGO, IL 60608-5736
(312) 804-2461
Mailing address
2545 S HILLOCK AVE, CHICAGO, IL 60608-5736
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
—
Other
Enumeration date
07/29/2019
Last updated
07/29/2019
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