Provider Demographics
NPI:1114671328
Name:SPINAL WELLNESS CHIROPRACTIC P.C.
Entity Type:Organization
Organization Name:SPINAL WELLNESS CHIROPRACTIC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNG
Authorized Official - Middle Name:WOOK
Authorized Official - Last Name:YOON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:347-401-3886
Mailing Address - Street 1:845 BROAD AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07657-1055
Mailing Address - Country:US
Mailing Address - Phone:347-401-3886
Mailing Address - Fax:
Practice Address - Street 1:845 BROAD AVE
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07657-1055
Practice Address - Country:US
Practice Address - Phone:347-401-3886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain