Provider Demographics
NPI:1669505541
Name:WOJCIK, KIM R (DC)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:R
Last Name:WOJCIK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:KIM
Other - Middle Name:R
Other - Last Name:HEDIGER WOJCIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:77 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08501-1609
Mailing Address - Country:US
Mailing Address - Phone:609-208-1582
Mailing Address - Fax:609-259-5658
Practice Address - Street 1:77 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08501-1609
Practice Address - Country:US
Practice Address - Phone:609-208-1582
Practice Address - Fax:609-259-5658
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00422400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJWO740668Medicare ID - Type UnspecifiedPROVIDER ID