Healthcare Provider Details

I. General information

NPI: 1699695213
Provider Name (Legal Business Name): RACHEL MARIE CHUNG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 BRANDON AVE
CHARLOTTESVLE VA
22903-3312
US

IV. Provider business mailing address

4 DEVONSHIRE LN
STAFFORD VA
22554-7692
US

V. Phone/Fax

Practice location:
  • Phone: 434-924-5362
  • Fax:
Mailing address:
  • Phone: 703-712-3603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: