Provider Demographics
NPI:1063510741
Name:VALLEY CHIROPRACTIC HEALTH CENTER
Entity Type:Organization
Organization Name:VALLEY CHIROPRACTIC HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:PUZIO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:302-234-4045
Mailing Address - Street 1:7460 LANCASTER PIKE
Mailing Address - Street 2:SUITE 8
Mailing Address - City:HOCKESSIN
Mailing Address - State:DE
Mailing Address - Zip Code:19707-9294
Mailing Address - Country:US
Mailing Address - Phone:302-234-4045
Mailing Address - Fax:302-234-4046
Practice Address - Street 1:7460 LANCASTER PIKE
Practice Address - Street 2:SUITE 8
Practice Address - City:HOCKESSIN
Practice Address - State:DE
Practice Address - Zip Code:19707-9294
Practice Address - Country:US
Practice Address - Phone:302-234-4045
Practice Address - Fax:302-234-4046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1994101299111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0758990000OtherKEYSTONE HEALTH PLAN EAST
PA0758990000OtherAMERIHEALTH
DE0758990000OtherINDEPENDENCE BLUE CROSS