Individual
DR. FERMIN ALBERTO DE LA JARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
12546 DILLINGHAM SQ, WOODBRIDGE, VA 22192-5259
(703) 730-6898
(703) 590-1260
Mailing address
3499 CONDOR LN, WOODBRIDGE, VA 22192-1061
(703) 491-8248
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
0104001510
VA
Other
Enumeration date
11/28/2005
Last updated
03/09/2011
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