Provider Demographics
NPI:1467690743
Name:T & J CHIROPRACTIC INC
Entity Type:Organization
Organization Name:T & J CHIROPRACTIC INC
Other - Org Name:ACTIVE CARE CHIROPRACTIC & ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JONG HEE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:703-539-8822
Mailing Address - Street 1:10680 MAIN ST
Mailing Address - Street 2:SUITE 275
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-3810
Mailing Address - Country:US
Mailing Address - Phone:703-539-8822
Mailing Address - Fax:703-539-8862
Practice Address - Street 1:10680 MAIN ST
Practice Address - Street 2:SUITE 275
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-3810
Practice Address - Country:US
Practice Address - Phone:703-539-8822
Practice Address - Fax:703-539-8862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-26
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556321111N00000X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty