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General NPI Number Information
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NPI Number | 1306114780
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Entity Type | Organization
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Legal Business Name | JONATHAN VU CHIROPRACTIC LLC
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Dates
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Enumeration Date | 12/13/2011
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Last Update Date | 12/13/2011
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Provider Practice Location Address
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Address Line | 6410 MALLORY DR
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City | RICHMOND
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State | VA
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Zip | 23226-2912
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Country | US
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Telephone | 804-228-8533
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Fax |
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Provider Business Mailing Address
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Address Line | 4082 TRISHA TRL
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City | MIDLOTHIAN
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State | VA
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Zip | 23112-3460
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Country | US
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Telephone | 804-405-6400
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Fax |
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Authorized Official
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Title or Position | PRACTITIONER
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Name | JONATHAN VU
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Credential | D.C.
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Telephone | 804-405-6400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 0104556895
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License Number State |
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