Provider Demographics
NPI:1902870520
Name:YUN, JEYOUNG (DC)
Entity Type:Individual
Prefix:DR
First Name:JEYOUNG
Middle Name:
Last Name:YUN
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 1:14416 JEFFERSON DAVIS HWY STE 12
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-2890
Mailing Address - Country:US
Mailing Address - Phone:571-572-3274
Mailing Address - Fax:571-572-3278
Practice Address - Street 1:14416 JEFFERSON DAVIS HWY STE 12
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-2890
Practice Address - Country:US
Practice Address - Phone:571-572-3274
Practice Address - Fax:571-572-3278
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556479111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor