MEDICARE: PRIMARY ZONE CHIROPRACTIC. PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	X010435	NY

General Provider Information

NPI Number	:	1114111994
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIMARY ZONE CHIROPRACTIC. PC

Provider Business Mailing Address
First Line	:	8908 ROOSEVELT AVE
Second Line	:	2ND FL.
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-7857
Country	:	US
Telephone Number	:	718-424-1454
Fax Number	:	718-424-1412

Provider Business Practice Location Address
First Line	:	8908 ROOSEVELT AVE
Second Line	:	2ND FL.
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-7857
Country	:	US
Telephone Number	:	718-424-1454
Fax Number	:	718-424-1412

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CHANG W WOO
Credential	:	D.C.
Telephone Number	:	718-424-1454

Provider Enumeration Date	:	09/05/2007
Last Update Date	:	09/05/2007

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