Provider Demographics
NPI:1619075330
Name:CHO, JONG HEE (DC)
Entity Type:Individual
Prefix:DR
First Name:JONG HEE
Middle Name:
Last Name:CHO
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 1:10680 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
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556321111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2136022OtherUNITED HEALTH CARE
VA254884OtherKAISER
VA671263OtherACN NUMBER
VA718260OtherNCPPO
VA176309OtherANTHEM BS/BC
VA254884OtherKAISER
VAV04854Medicare UPIN