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General NPI Number Information
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NPI Number | 1871142075
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Entity Type | Individual
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Provider Name | CHAEYEUN JEON L.AC
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Gender | Female
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Dates
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Enumeration Date | 09/10/2019
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 10301 DEMOCRACY LN STE 110C
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City | FAIRFAX
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State | VA
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Zip | 22030-2545
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Country | US
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Telephone | 202-743-4122
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Fax |
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Provider Business Mailing Address
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Address Line | 12148 GARDEN GROVE CIR UNIT 301
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City | FAIRFAX
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State | VA
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Zip | 22030-9017
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Country | US
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Telephone | 703-307-7740
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 0121000936
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License Number State | VA
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