Provider Demographics
NPI:1720153927
Name:WONG, ALECK (DC)
Entity Type:Individual
Prefix:DR
First Name:ALECK
Middle Name:
Last Name:WONG
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 1:1721 GOSNELL RD
Mailing Address - Street 2:APT#201
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2547
Mailing Address - Country:US
Mailing Address - Phone:703-439-0148
Mailing Address - Fax:
Practice Address - Street 1:1076 ELDEN ST
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-3803
Practice Address - Country:US
Practice Address - Phone:703-437-8195
Practice Address - Fax:703-437-2404
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0-104-556-294111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor