Provider Demographics
NPI:1073244802
Name:KWON CHIROPRACTIC P.C.
Entity Type:Organization
Organization Name:KWON CHIROPRACTIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SO
Authorized Official - Middle Name:YOUNG
Authorized Official - Last Name:KWON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:201-983-7963
Mailing Address - Street 1:455 CENTRAL PARK AVE STE 208
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-1034
Mailing Address - Country:US
Mailing Address - Phone:201-983-7963
Mailing Address - Fax:914-685-6720
Practice Address - Street 1:455 CENTRAL PARK AVE STE 208
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-1034
Practice Address - Country:US
Practice Address - Phone:201-983-7963
Practice Address - Fax:914-685-6720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty