| Organization Name: | NOVA GONSTEAD CHIROPRACTIC CLINIC PLLC |
| NPI Number: | 1356602049 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MIN KOO KANG (DIRECTOR) |
| Mailing Address: | 360 Maple Ave W Suite B Vienna |
| State: | VA US |
| Postal Code: | 221805614 |
| Phone Number: | 7037744006 |
| Fax Number: | 7032810391 |
| NPI Enumeration Date: | 05/30/2012 |
| NPI Last Update Date: | 05/17/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 111N00000X |
| License Number: | 0104556856 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Chiropractic Providers |
| Taxonomy Classification: | Chiropractor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |