Provider Demographics
NPI:1407538614
Name:CHUDZIKIEWICZ, ADAM EDWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:EDWARD
Last Name:CHUDZIKIEWICZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:340 MAPLE ST STE 101
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-3200
Mailing Address - Country:US
Mailing Address - Phone:508-481-1133
Mailing Address - Fax:508-229-0609
Practice Address - Street 1:340 MAPLE ST STE 101
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-3200
Practice Address - Country:US
Practice Address - Phone:508-481-1133
Practice Address - Fax:508-229-0609
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MACHI3833111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor