Organization
MOMENTUM CHIROPRACTIC AND REHAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESUS MANUEL DIAZ JR. D.C. (OWNER/DOCTOR)
(703) 369-2559
Entity
Organization
Contact information
Practice address
9408 GRANT AVE, SUITE 202, MANASSAS, VA 20110-5511
(703) 369-2559
(703) 369-2733
Mailing address
9408 GRANT AVE, SUITE 202, MANASSAS, VA 20110-5511
(703) 369-2559
(703) 369-2733
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104556989
VA
Other
Enumeration date
07/10/2012
Last updated
07/10/2012
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