Individual
PETER TAEJOO JEONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
10721 MAIN ST STE G7, FAIRFAX, VA 22030-6913
(703) 814-6650
Mailing address
10721 MAIN ST STE G7, FAIRFAX, VA 22030-6913
(703) 814-6650
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104556735
VA
Other
Enumeration date
08/20/2009
Last updated
07/21/2022
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