Individual
KIYOSHI YAMAMOTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC., LMT
Contact information
Practice address
1033 STERLING RD STE 105, HERNDON, VA 20170-3837
(703) 855-3514
Mailing address
5104 CASTLE HARBOR WAY, CENTREVILLE, VA 20120-4140
(703) 855-3514
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
0121000947
VA
225700000X
Massage Therapist
19003726
VA
Other
Enumeration date
12/07/2010
Last updated
08/31/2021
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