Provider Demographics
NPI:1790723781
Name:LACHCIK, JASIA (DC)
Entity Type:Individual
Prefix:DR
First Name:JASIA
Middle Name:
Last Name:LACHCIK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:JASIA
Other - Middle Name:
Other - Last Name:LACHCIK-COSTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:333 N OXFORD VALLEY RD
Mailing Address - Street 2:STE. 402
Mailing Address - City:FAIRLESS HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19030-2624
Mailing Address - Country:US
Mailing Address - Phone:215-943-2584
Mailing Address - Fax:
Practice Address - Street 1:333 N OXFORD VALLEY RD
Practice Address - Street 2:STE. 402
Practice Address - City:FAIRLESS HILLS
Practice Address - State:PA
Practice Address - Zip Code:19030-2624
Practice Address - Country:US
Practice Address - Phone:215-943-2584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA6071111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCFTWMedicare UPIN