Provider Demographics
NPI:1811918188
Name:JEFFREY M JAMES DC PC
Entity type:Organization
Organization Name:JEFFREY M JAMES DC PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:MADISON
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:703-369-4111
Mailing Address - Street 1:9151 KEY COMMONS COURT
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110
Mailing Address - Country:US
Mailing Address - Phone:703-369-4111
Mailing Address - Fax:703-369-4317
Practice Address - Street 1:9151 KEY COMMONS COURT
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110
Practice Address - Country:US
Practice Address - Phone:703-369-4111
Practice Address - Fax:703-369-4317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000626111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty