Provider Demographics
NPI:1013157494
Name:LIM, JUNWOO (DC)
Entity Type:Individual
Prefix:
First Name:JUNWOO
Middle Name:
Last Name:LIM
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 1:11130 FAIRFAX BLVD STE 206
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-5035
Mailing Address - Country:US
Mailing Address - Phone:571-205-6328
Mailing Address - Fax:
Practice Address - Street 1:11130 FAIRFAX BLVD STE 206
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-5035
Practice Address - Country:US
Practice Address - Phone:571-205-6328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-25
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556689111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor