Dr Cheon Gyu Park, DC | |
3900 University Dr Ste 100, Fairfax, VA 22030-2513 | |
(571) 253-5539 | |
Not Available |
Full Name | Dr Cheon Gyu Park |
---|---|
Gender | Male |
Speciality | Chiropractor |
Location | 3900 University Dr Ste 100, Fairfax, Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1649699109 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 0104557163 (Virginia) | Primary |
Provider Name | Chiropractic Works2 Llc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1326550419 PECOS PAC ID: 2062773450 Enrollment ID: O20180227002537 |
Provider Name | Whole Body Healthcare Parkville Llc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1578139291 PECOS PAC ID: 8022413913 Enrollment ID: O20210816001122 |
Mailing Address | Practice Location Address |
---|---|
Dr Cheon Gyu Park, DC 3900 University Dr Ste 100, Fairfax, VA 22030-2513 Ph: (571) 253-5539 | Dr Cheon Gyu Park, DC 3900 University Dr Ste 100, Fairfax, VA 22030-2513 Ph: (571) 253-5539 |
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