Individual
DR. JILL RENAE DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
9244 CHURCH ST, MANASSAS, VA 20110-5543
(703) 369-2559
(703) 369-2733
Mailing address
9244 CHURCH ST, MANASSAS, VA 20110-5543
(703) 369-2559
(703) 369-2733
Taxonomy
Speciality
Code
Description
License number
State
111NP0017X
Pediatric Chiropractor
Primary
0104556990
VA
Other
Enumeration date
04/27/2012
Last updated
05/20/2013
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