Provider Demographics
NPI:1588430946
Name:MIN CHIROPRACTIC LLC
Entity type:Organization
Organization Name:MIN CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIN
Authorized Official - Middle Name:H
Authorized Official - Last Name:YUN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:571-425-5523
Mailing Address - Street 1:9346 TARTAN VIEW DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22032-1206
Mailing Address - Country:US
Mailing Address - Phone:571-425-5523
Mailing Address - Fax:
Practice Address - Street 1:5105A BACKLICK RD
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-6005
Practice Address - Country:US
Practice Address - Phone:703-680-3332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-28
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty