Provider Demographics
NPI:1215176763
Name:CHOI, SOON YO (L AC)
Entity type:Individual
Prefix:
First Name:SOON YO
Middle Name:
Last Name:CHOI
Suffix:
Gender:M
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8565 SUDLEY RD
Mailing Address - Street 2:B
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-3864
Mailing Address - Country:US
Mailing Address - Phone:703-396-9001
Mailing Address - Fax:703-396-9001
Practice Address - Street 1:8565 SUDLEY RD
Practice Address - Street 2:B
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-3864
Practice Address - Country:US
Practice Address - Phone:703-396-9001
Practice Address - Fax:703-396-9001
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-06
Last Update Date:2009-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000388171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist