Provider Demographics
NPI:1437233020
Name:HOMZA, JOHN J (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:J
Last Name:HOMZA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5721 LINGLESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-1118
Mailing Address - Country:US
Mailing Address - Phone:717-541-9311
Mailing Address - Fax:717-540-1211
Practice Address - Street 1:5721 LINGLESTOWN RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-1118
Practice Address - Country:US
Practice Address - Phone:717-541-9311
Practice Address - Fax:717-540-1211
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC004656-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU13570Medicare UPIN
PA663597WP6Medicare PIN
PA197339Medicare PIN