Organization
BALANCE ART WELLNESS CENTER PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUN GUO L.AC (CEO)
(786) 532-4722
Entity
Organization
Contact information
Practice address
301 MAPLE AVE W STE 210, VIENNA, VA 22180-4301
(786) 532-4722
Mailing address
301 MAPLE AVE W STE 210, VIENNA, VA 22180-4301
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0121000840
ACUPUNCTURE
VA
Enumeration date
06/13/2022
Last updated
06/13/2022
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