Individual
MICAH JOHNSRUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2778 WASHINGTON BLVD, ARLINGTON, VA 22201-1945
(571) 568-8508
Mailing address
1911 R ST NW, WASHINGTON, DC 20009-1036
(715) 821-0958
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104557977
VA
Other
Enumeration date
05/09/2024
Last updated
05/09/2024
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