Provider Demographics
NPI:1053760694
Name:COMMUNITY HEALTH ACUPUNCTURE
Entity type:Organization
Organization Name:COMMUNITY HEALTH ACUPUNCTURE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MING
Authorized Official - Middle Name:
Authorized Official - Last Name:SU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-318-0128
Mailing Address - Street 1:3601 W HUNDRED RD STE 3
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:23831-1901
Mailing Address - Country:US
Mailing Address - Phone:804-318-0128
Mailing Address - Fax:804-621-0196
Practice Address - Street 1:11500 CHESTER VILLAGE DR
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-1797
Practice Address - Country:US
Practice Address - Phone:804-318-0128
Practice Address - Fax:804-621-0196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-05
Last Update Date:2016-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000645171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty