Provider Demographics
NPI:1194406926
Name:RESTORATIVE YIN WELLNESS CENTER LLC
Entity type:Organization
Organization Name:RESTORATIVE YIN WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:GI MIN
Authorized Official - Middle Name:
Authorized Official - Last Name:OH
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:715-297-7795
Mailing Address - Street 1:6719 SARISSA DR
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-7728
Mailing Address - Country:US
Mailing Address - Phone:715-297-7795
Mailing Address - Fax:
Practice Address - Street 1:500 N 3RD ST STE 208-1
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54403-4885
Practice Address - Country:US
Practice Address - Phone:715-297-7795
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-25
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty