Provider Demographics
NPI:1871788786
Name:DR. JAIME CHICA DC, PLC
Entity type:Organization
Organization Name:DR. JAIME CHICA DC, PLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAIME
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHICA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:703-379-6300
Mailing Address - Street 1:5555 COLUMBIA PIKE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-3117
Mailing Address - Country:US
Mailing Address - Phone:703-379-6300
Mailing Address - Fax:703-379-4440
Practice Address - Street 1:5555 COLUMBIA PIKE
Practice Address - Street 2:SUITE 201
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-5852
Practice Address - Country:US
Practice Address - Phone:703-379-6300
Practice Address - Fax:703-379-4440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-13
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104002042111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAG02667Medicare PIN