Provider Demographics
NPI:1326354663
Name:DUCHEK, MEGAN JEAN (DC)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:JEAN
Last Name:DUCHEK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3235 RIDDLE RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95117-2248
Mailing Address - Country:US
Mailing Address - Phone:847-767-9523
Mailing Address - Fax:408-520-4590
Practice Address - Street 1:1373 S BASCOM AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-4507
Practice Address - Country:US
Practice Address - Phone:408-288-8120
Practice Address - Fax:408-520-4590
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-24
Last Update Date:2011-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-31645111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor