Provider Demographics
NPI:1508174822
Name:CZOP, ANDREA (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:
Last Name:CZOP
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 1:3157 SUGARLOAF PKWY
Mailing Address - Street 2:SUITE 130
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045-9490
Mailing Address - Country:US
Mailing Address - Phone:678-828-4114
Mailing Address - Fax:
Practice Address - Street 1:3157 SUGARLOAF PKWY
Practice Address - Street 2:SUITE 130
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30045-9490
Practice Address - Country:US
Practice Address - Phone:678-828-4114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-21
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00684500111N00000X
GACHIR008781111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor