Provider Demographics
NPI:1689688160
Name:POKOWICZ, STEPHEN A (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:A
Last Name:POKOWICZ
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 1:1186 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:MOSCOW
Mailing Address - State:PA
Mailing Address - Zip Code:18444-9346
Mailing Address - Country:US
Mailing Address - Phone:570-842-5131
Mailing Address - Fax:570-842-5126
Practice Address - Street 1:1186 CHURCH ST
Practice Address - Street 2:
Practice Address - City:MOSCOW
Practice Address - State:PA
Practice Address - Zip Code:18444-9346
Practice Address - Country:US
Practice Address - Phone:570-842-5131
Practice Address - Fax:570-842-5126
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC5669-L111N00000X
PAAJ5669L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
D0074692OtherBCBS
U50976Medicare UPIN
D0074692OtherBCBS