Provider Demographics
NPI:1215083209
Name:WHANG, QBAEK (ACUPUNCTURIST LAC)
Entity type:Individual
Prefix:MR
First Name:QBAEK
Middle Name:
Last Name:WHANG
Suffix:
Gender:M
Credentials:ACUPUNCTURIST LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 HICKORY LANE
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:VA
Mailing Address - Zip Code:22664
Mailing Address - Country:US
Mailing Address - Phone:540-535-0083
Mailing Address - Fax:
Practice Address - Street 1:158 FRONT ROYAL PIKE
Practice Address - Street 2:SUITE 103
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22602
Practice Address - Country:US
Practice Address - Phone:540-535-0083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000184171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist