Individual
JESUS MANUEL DIAZ JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
9408 GRANT AVE, SUITE 202, MANASSAS, VA 20110-5511
(703) 369-2559
(703) 369-2733
Mailing address
9408 GRANT AVE, SUITE 202, MANASSAS, VA 20110-5511
(703) 369-2559
(703) 369-2733
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104556989
VA
111N00000X
Chiropractor
0105473
KS
Other
Enumeration date
07/01/2012
Last updated
07/01/2012
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