Provider Demographics
NPI:1992985451
Name:CHOO, ELLEN BOHYUNG (DC)
Entity type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:BOHYUNG
Last Name:CHOO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10721 MAIN ST STE G8
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-6912
Mailing Address - Country:US
Mailing Address - Phone:703-383-9212
Mailing Address - Fax:703-383-9214
Practice Address - Street 1:10721 MAIN ST STE G8
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-6912
Practice Address - Country:US
Practice Address - Phone:703-383-9212
Practice Address - Fax:703-383-9214
Is Sole Proprietor?:No
Enumeration Date:2007-11-13
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104555868111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor