Provider Demographics
NPI:1013041656
Name:KWON, JOSEPH Y (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:Y
Last Name:KWON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4107 JACKSON DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19444-1503
Mailing Address - Country:US
Mailing Address - Phone:215-888-8880
Mailing Address - Fax:
Practice Address - Street 1:1950 COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-1738
Practice Address - Country:US
Practice Address - Phone:215-396-8494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007728L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor