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Organization

PROCARE ACUPUNCTURE AND WELLNESS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PUKAI JIN DOM (ACUPUNCTURIST)
(571) 207-6789
Entity
Organization

Contact information

Practice address
3007 WILLIAMS DR, FAIRFAX, VA 22031-4612
(571) 207-6789
Mailing address
7349 RHONDDA DR, LORTON, VA 22079-1570
(813) 260-6263

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
261Q00000X
Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1457149940
ACUPUNCTURE
VA
01
1477219616
ACUPUNCTURE
VA
Enumeration date
05/14/2025
Last updated
05/17/2025
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