Provider Demographics
NPI:1447430988
Name:MICHAUX, RANDOLPH MILLER JR (DC)
Entity Type:Individual
Prefix:DR
First Name:RANDOLPH
Middle Name:MILLER
Last Name:MICHAUX
Suffix:JR
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 1:3659 LA HARVE PL
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-8406
Mailing Address - Country:US
Mailing Address - Phone:703-580-6443
Mailing Address - Fax:
Practice Address - Street 1:3659 LA HARVE PL
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-8406
Practice Address - Country:US
Practice Address - Phone:703-580-6443
Practice Address - Fax:
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
VA0104556588111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor