Provider Demographics
NPI:1538715131
Name:BALANCE ACUPUNCTURE & WELLNESS CENTER LLC
Entity type:Organization
Organization Name:BALANCE ACUPUNCTURE & WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:MR
Authorized Official - First Name:SANG
Authorized Official - Middle Name:KWON
Authorized Official - Last Name:HONG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:443-812-0857
Mailing Address - Street 1:3454 ELLICOTT CENTER DR STE 104
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-4130
Mailing Address - Country:US
Mailing Address - Phone:410-465-8012
Mailing Address - Fax:
Practice Address - Street 1:3454 ELLICOTT CENTER DR STE 104
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-4130
Practice Address - Country:US
Practice Address - Phone:410-465-8012
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-11
Last Update Date:2019-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty