Provider Demographics
NPI:1588980619
Name:EASTERN HEALING CENTER
Entity type:Organization
Organization Name:EASTERN HEALING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:OWEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIAO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:301-519-2346
Mailing Address - Street 1:604 S FREDERICK AVE
Mailing Address - Street 2:SUITE 407
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877-1275
Mailing Address - Country:US
Mailing Address - Phone:301-519-2346
Mailing Address - Fax:301-519-2346
Practice Address - Street 1:604 S FREDERICK AVE
Practice Address - Street 2:SUITE 407
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20877-1275
Practice Address - Country:US
Practice Address - Phone:301-519-2346
Practice Address - Fax:301-519-2346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-14
Last Update Date:2012-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU01127171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty