Healthcare Provider Details

I. General information

NPI: 1942503156
Provider Name (Legal Business Name): JEAN EXUME D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2010
Last Update Date: 02/10/2022
Certification Date: 02/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4107 PLANK RD STE A
FREDERICKSBURG VA
22407-0113
US

IV. Provider business mailing address

4107 PLANK RD STE A
FREDERICKSBURG VA
22407-0113
US

V. Phone/Fax

Practice location:
  • Phone: 540-710-5843
  • Fax: 888-616-6308
Mailing address:
  • Phone: 540-710-5843
  • Fax: 888-616-6308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number0104556809
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: