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General NPI Number Information
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NPI Number | 1073244802
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Entity Type | Organization
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Legal Business Name | KWON CHIROPRACTIC P.C.
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Dates
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Enumeration Date | 06/22/2022
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Last Update Date | 06/22/2022
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Provider Practice Location Address
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Address Line | 455 CENTRAL PARK AVE STE 208
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City | SCARSDALE
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State | NY
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Zip | 10583-1034
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Country | US
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Telephone | 201-983-7963
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Fax | 914-685-6720
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Provider Business Mailing Address
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Address Line | 455 CENTRAL PARK AVE STE 208
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City | SCARSDALE
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State | NY
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Zip | 10583-1034
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Country | US
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Telephone | 201-983-7963
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Fax | 914-685-6720
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Authorized Official
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Title or Position | OWNER
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Name | SO YOUNG KWON
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Credential | DC
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Telephone | 201-983-7963
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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