Provider Demographics
NPI:1871665513
Name:SZOSTCZUK, MARK (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:SZOSTCZUK
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 1:1378 HENDERSONVILLE RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-1957
Mailing Address - Country:US
Mailing Address - Phone:828-274-1122
Mailing Address - Fax:828-274-3366
Practice Address - Street 1:1550 HENDERSONVILLE RD
Practice Address - Street 2:SUITE 104
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-3187
Practice Address - Country:US
Practice Address - Phone:828-274-1122
Practice Address - Fax:828-274-3366
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2957111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC085E0OtherNCBCBS
NC89085E0Medicaid
NC085E0OtherNCBCBS