Provider Demographics
NPI:1902659444
Name:HAN, BRIAN (AP LAC)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:HAN
Suffix:
Gender:M
Credentials:AP LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9819 W SAMPLE RD
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-4005
Mailing Address - Country:US
Mailing Address - Phone:954-255-7888
Mailing Address - Fax:
Practice Address - Street 1:9819 W SAMPLE RD
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4005
Practice Address - Country:US
Practice Address - Phone:954-255-7888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP-805171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist