Individual
JAIME DIANA LUCIANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
102 ELDEN ST, SUITE 13, HERNDON, VA 20170-4868
(703) 742-5470
(703) 742-0435
Mailing address
49 SPILLWAY CT, MARTINSBURG, WV 25405-6394
(703) 919-8691
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104556668
VA
Other
Enumeration date
06/12/2008
Last updated
12/19/2008
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