Provider Demographics
NPI:1912639121
Name:ACUPUNCTURE AT THE PAVILION, LLC
Entity type:Organization
Organization Name:ACUPUNCTURE AT THE PAVILION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KYUNG YUN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHUMAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-635-6549
Mailing Address - Street 1:261 OLD YORK RD STE 333
Mailing Address - Street 2:
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-3710
Mailing Address - Country:US
Mailing Address - Phone:215-635-6549
Mailing Address - Fax:
Practice Address - Street 1:261 OLD YORK RD STE 333
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-3710
Practice Address - Country:US
Practice Address - Phone:215-887-3712
Practice Address - Fax:215-893-5366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-27
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty