Provider Demographics
NPI:1730221359
Name:JUNG, JIHYUN (DC)
Entity type:Individual
Prefix:DR
First Name:JIHYUN
Middle Name:
Last Name:JUNG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13880 BRADDOCK RD STE 102
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20121-2460
Mailing Address - Country:US
Mailing Address - Phone:703-830-0993
Mailing Address - Fax:
Practice Address - Street 1:7535 LITTLE RIVER TPKE STE 200B
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-2988
Practice Address - Country:US
Practice Address - Phone:703-256-3005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104555840111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor