Provider Demographics
NPI:1790357606
Name:ZULKOSKI FAMILY CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:ZULKOSKI FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:ZULKOSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:570-574-9265
Mailing Address - Street 1:400 3RD AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18704-5816
Mailing Address - Country:US
Mailing Address - Phone:570-763-7270
Mailing Address - Fax:
Practice Address - Street 1:400 3RD AVE STE 108
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-5816
Practice Address - Country:US
Practice Address - Phone:570-763-7270
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty