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Individual

MR. JE UN YOO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
L.AC,M.AC,DIP'L.AC

Contact information

Practice address
4208 EVERGREEN LN, SUITE 224, ANNANDALE, VA 22003-3235
(703) 642-3300
Mailing address
4208 EVERGREEN LN, SUITE 224, ANNANDALE, VA 22003-3235
(703) 642-3300

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
0121000519
VA
171100000X
Acupuncturist
U01636
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0121000519
COMMONWELTH OF VIRGINIA
VA
01
108692
NCCAOM
01
U01636
STATE OF MARYLAND BOARD OF ACUPUNCTURE
MD
Enumeration date
03/09/2009
Last updated
03/09/2009
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