Provider Demographics
NPI:1922257328
Name:GO, JAMES (DC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:GO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:12104 MAPLE FOREST CT APT D
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-7719
Mailing Address - Country:US
Mailing Address - Phone:607-329-8135
Mailing Address - Fax:703-865-6161
Practice Address - Street 1:10507 BRADDOCK RD STE A
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22032-2240
Practice Address - Country:US
Practice Address - Phone:607-329-8135
Practice Address - Fax:703-865-6161
Is Sole Proprietor?:No
Enumeration Date:2008-09-10
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556606111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor