Provider Demographics
NPI:1336116839
Name:CHU, ERIC TEH-CHUAN (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:TEH-CHUAN
Last Name:CHU
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 1:9689 MAIN ST
Mailing Address - Street 2:STE B
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-3764
Mailing Address - Country:US
Mailing Address - Phone:703-323-0068
Mailing Address - Fax:703-323-0068
Practice Address - Street 1:9689 MAIN ST
Practice Address - Street 2:STE B
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-3764
Practice Address - Country:US
Practice Address - Phone:703-323-0068
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-02
Last Update Date:2019-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104555900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA490904Medicare ID - Type Unspecified