Provider Demographics
NPI:1598321630
Name:EVAN H CHUNG CHIROPRACTIC
Entity Type:Organization
Organization Name:EVAN H CHUNG CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EVAN
Authorized Official - Middle Name:HOIYUP
Authorized Official - Last Name:CHUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DC, MS
Authorized Official - Phone:410-747-1578
Mailing Address - Street 1:516 N ROLLING RD STE 205
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4187
Mailing Address - Country:US
Mailing Address - Phone:410-747-1578
Mailing Address - Fax:410-747-1517
Practice Address - Street 1:516 N ROLLING RD STE 205
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4187
Practice Address - Country:US
Practice Address - Phone:410-747-1578
Practice Address - Fax:410-747-1517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-14
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty