MEDICARE: PILSEOG JEONG D.C.

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	CH00034412	WA
2	111N00000X	Chiropractor	DC011909	PA

General Provider Information

NPI Number	:	1669683785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PILSEOG JEONG D.C.

Provider Business Mailing Address
First Line	:	981 N WALES RD STE 13
Second Line	:
City	:	NORTH WALES
State	:	PA
Zip	:	19454-1422
Country	:	US
Telephone Number	:	267-421-5470
Fax Number	:

Provider Business Practice Location Address
First Line	:	981 N WALES RD STE 13
Second Line	:
City	:	NORTH WALES
State	:	PA
Zip	:	19454-1422
Country	:	US
Telephone Number	:	267-421-5470
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	03/11/2025

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Directions to “ PILSEOG JEONG D.C.” Practice Location

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