Provider Demographics
NPI:1013000587
Name:YOO, SEUNG WON (DC)
Entity Type:Individual
Prefix:DR
First Name:SEUNG
Middle Name:WON
Last Name:YOO
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 1:610 THIMBLE SHOALS BLVD.
Mailing Address - Street 2:SUITE 202-A
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4511
Mailing Address - Country:US
Mailing Address - Phone:757-594-9412
Mailing Address - Fax:757-594-9413
Practice Address - Street 1:610 THIMBLE SHOALS BLVD.
Practice Address - Street 2:SUITE 202-A
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4511
Practice Address - Country:US
Practice Address - Phone:757-594-9412
Practice Address - Fax:757-594-9413
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556213111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor