Provider Demographics
NPI:1538315742
Name:CHOI, YOUNG R (DC)
Entity Type:Individual
Prefix:DR
First Name:YOUNG
Middle Name:R
Last Name:CHOI
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 1:10721 MAIN ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030
Mailing Address - Country:US
Mailing Address - Phone:703-599-0184
Mailing Address - Fax:703-986-1827
Practice Address - Street 1:10721 MAIN ST
Practice Address - Street 2:SUITE 104
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030
Practice Address - Country:US
Practice Address - Phone:703-599-0184
Practice Address - Fax:703-986-1827
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-07
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556629111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor