Provider Demographics
NPI:1548523889
Name:ZOCK FAMILY CHIROPRACTIC LLC
Entity type:Organization
Organization Name:ZOCK FAMILY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KERSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:917-557-2234
Mailing Address - Street 1:730 PARKWOOD DR
Mailing Address - Street 2:SUITE 500
Mailing Address - City:CRANBERRY TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-6312
Mailing Address - Country:US
Mailing Address - Phone:917-557-2234
Mailing Address - Fax:
Practice Address - Street 1:730 PARKWOOD DR
Practice Address - Street 2:SUITE 500
Practice Address - City:CRANBERRY TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:16066-6312
Practice Address - Country:US
Practice Address - Phone:917-557-2234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010431261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1891015202OtherNPI