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Individual

MRS. MIN JIN JUNG DETRICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
8100 BOONE BLVD STE 700, TYSONS, VA 22182-2683
(703) 531-2269
Mailing address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3307
(703) 776-4001
(703) 776-7113

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-01553
NC
363A00000X
Physician Assistant
Primary
0110003714
VA

Other

Enumeration date
09/29/2008
Last updated
03/28/2024
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