Organization
RENEWED ORIENTAL MEDICINE CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SOLOMON WANSOO LEE DAOM (OWNER)
(703) 577-0639
Entity
Organization
Contact information
Practice address
9685 MAIN ST STE C, FAIRFAX, VA 22031-3752
(703) 577-0639
Mailing address
9685 MAIN ST STE C, FAIRFAX, VA 22031-3752
(703) 577-0639
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
07/07/2020
Last updated
07/07/2020
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