Provider Demographics
NPI:1588995278
Name:CHU, YOUNG IMKIM (ACUPUNCTURIST)
Entity type:Individual
Prefix:MRS
First Name:YOUNG
Middle Name:IMKIM
Last Name:CHU
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14637 LEE HWY STE 204
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20121-5832
Mailing Address - Country:US
Mailing Address - Phone:703-830-8533
Mailing Address - Fax:703-830-8533
Practice Address - Street 1:14637 LEE HWY STE 204
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20121-5832
Practice Address - Country:US
Practice Address - Phone:703-830-8533
Practice Address - Fax:703-830-8533
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0121000546171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist