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General NPI Number Information
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NPI Number | 1679695399
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Entity Type | Individual
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Provider Name | CHIN-SUK JOHN CHO D.C, DACBR, RMSK
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Gender | Male
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 525 W CHESTER PIKE SUITE #103A
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City | HAVERTOWN
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State | PA
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Zip | 19083-4500
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Country | US
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Telephone | 610-789-3678
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Fax | 610-789-3679
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Provider Business Mailing Address
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Address Line | 2550 STATE HWY 121 BUILDING 2
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City | LEWISVILLE
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State | TX
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Zip | 75067
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0200X
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Taxonomy Name | Radiology Chiropractor
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License Number | 13616
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License Number State | TX
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