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General NPI Number Information
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NPI Number | 1649522947
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Entity Type | Organization
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Legal Business Name | JM CHIROPRACTIC CLINIC, PLLC
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Dates
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Enumeration Date | 10/10/2012
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Last Update Date | 10/10/2012
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Provider Practice Location Address
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Address Line | 6400 SEVEN CORNERS PL F
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City | FALLS CHURCH
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State | VA
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Zip | 22044-2009
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Country | US
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Telephone | 703-388-9488
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Fax |
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Provider Business Mailing Address
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Address Line | 6400 SEVEN CORNERS PL F
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City | FALLS CHURCH
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State | VA
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Zip | 22044-2009
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Country | US
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Telephone | 703-388-9488
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. THIEN MA CAO MA
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Credential | D.C.
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Telephone | 703-209-7299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 0104556939
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License Number State | VA
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