Provider Demographics
NPI:1144642471
Name:JANG, HYUK JUN
Entity type:Individual
Prefix:MR
First Name:HYUK JUN
Middle Name:
Last Name:JANG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2917 MONROE PL
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-2123
Mailing Address - Country:US
Mailing Address - Phone:571-269-7555
Mailing Address - Fax:
Practice Address - Street 1:2917 MONROE PL
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-2123
Practice Address - Country:US
Practice Address - Phone:571-269-7555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-06
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0019009503225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist