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NPI 1124388996

NPI 1124388996 : KIM WOJCIK DC LLC : ALLENTOWN, NJ

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General NPI Number Information
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    NPI Number           |    1124388996
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    Entity Type          |    Organization 
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    Legal Business Name  |    KIM WOJCIK DC LLC 
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Dates
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    Enumeration Date     |    05/25/2012
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    Last Update Date     |    05/25/2012
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Provider Practice Location Address
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    Address Line         |    77 N MAIN ST 
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    City                 |    ALLENTOWN
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    State                |    NJ
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    Zip                  |    08501-1609
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    Country              |    US
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    Telephone            |    609-208-1582
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    Fax                  |    609-259-5658
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Provider Business Mailing Address
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    Address Line         |    77 N MAIN ST 
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    City                 |    ALLENTOWN
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    State                |    NJ
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    Zip                  |    08501-1609
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    Country              |    US
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    Telephone            |    609-208-1582
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    Fax                  |    609-259-5658
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Authorized Official
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    Title or Position    |    SOLE MEMBER
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    Name                 |     KIM  WOJCIK 
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    Credential           |    D.C.
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    Telephone            |    609-208-1582
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    111N00000X
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    Taxonomy Name        |    Chiropractor
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    License Number       |    38MC00422400
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    License Number State |    NJ
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