Individual
RONALD CHARLES WICHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
104 ELDEN ST, HERNDON, VA 20170-4871
(703) 834-1910
(703) 834-2609
Mailing address
104 ELDEN ST, HERNDON, VA 20170-4825
(703) 834-1910
(703) 834-2609
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104000656
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050949
BLUE CROSS BLUE SHIELD
VA
Enumeration date
06/03/2006
Last updated
07/08/2007
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