Provider Demographics
NPI:1851465942
Name:KUCZMARSKI, ERIN J (DC)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:J
Last Name:KUCZMARSKI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 W MILLBROOK RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-4369
Mailing Address - Country:US
Mailing Address - Phone:919-676-2225
Mailing Address - Fax:
Practice Address - Street 1:104 W MILLBROOK RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-4369
Practice Address - Country:US
Practice Address - Phone:919-676-2225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1347111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8908575Medicaid
NC8908575Medicaid
NC244386AMedicare ID - Type Unspecified