Provider Demographics
NPI:1417098179
Name:LE, VIET (DC)
Entity Type:Individual
Prefix:DR
First Name:VIET
Middle Name:
Last Name:LE
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 1:115 BEULAH RD NE STE 100D
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-4712
Mailing Address - Country:US
Mailing Address - Phone:703-729-5600
Mailing Address - Fax:703-890-2444
Practice Address - Street 1:115 BEULAH RD NE STE 100D
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4712
Practice Address - Country:US
Practice Address - Phone:703-729-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104555970111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0104555970OtherSTATE LICENSURE
VA0104555970OtherSTATE LICENSURE
U88905Medicare UPIN