Provider Demographics
NPI:1508474057
Name:HAN, YOUNG HWAN (DC)
Entity Type:Individual
Prefix:DR
First Name:YOUNG HWAN
Middle Name:
Last Name:HAN
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 1:8100 BOONE BLVD STE 250
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2642
Mailing Address - Country:US
Mailing Address - Phone:571-378-0780
Mailing Address - Fax:571-378-0784
Practice Address - Street 1:8100 BOONE BLVD STE 250
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-2642
Practice Address - Country:US
Practice Address - Phone:571-378-0780
Practice Address - Fax:571-378-0784
Is Sole Proprietor?:No
Enumeration Date:2020-07-21
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104-557664111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor