Provider Demographics
NPI:1538938477
Name:LU ACUPUNCTURE & HERB CLINIC LLC
Entity type:Organization
Organization Name:LU ACUPUNCTURE & HERB CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/HEALTH CARE PROVIDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LU
Authorized Official - Middle Name:H
Authorized Official - Last Name:PHOUN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC ACUPUNCTURIST
Authorized Official - Phone:770-268-1801
Mailing Address - Street 1:211 PROME POINT, BLDG 2
Mailing Address - Street 2:STE F
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269
Mailing Address - Country:US
Mailing Address - Phone:770-268-1801
Mailing Address - Fax:470-407-6985
Practice Address - Street 1:211 PROME POINT, BLDG 2
Practice Address - Street 2:STE F
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269
Practice Address - Country:US
Practice Address - Phone:770-268-1801
Practice Address - Fax:470-407-6985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-20
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty