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Individual

DR. KYUNG JAE LEE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C

Contact information

Practice address
209 ELDEN ST STE 302, HERNDON, VA 20170-4847
(703) 520-9980
Mailing address
209 ELDEN ST STE 302, HERNDON, VA 20170-4847
(571) 451-4505

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104557322
VA
111NR0400X
Rehabilitation Chiropractor
0104557322
VA

Other

Enumeration date
05/24/2016
Last updated
03/24/2020
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