Provider Demographics
NPI:1285064238
Name:SANG'S SPINE AND REHAB CENTER INC.
Entity type:Organization
Organization Name:SANG'S SPINE AND REHAB CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:SANGWON
Authorized Official - Middle Name:
Authorized Official - Last Name:JUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-706-3358
Mailing Address - Street 1:9020 OLD GEORGETOWN RD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-1514
Mailing Address - Country:US
Mailing Address - Phone:240-223-2500
Mailing Address - Fax:240-223-2502
Practice Address - Street 1:9020 OLD GEORGETOWN RD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-1514
Practice Address - Country:US
Practice Address - Phone:240-223-2500
Practice Address - Fax:240-223-2502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-12
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS02086111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty