Provider Demographics
NPI:1952479016
Name:CHUNG, KY (DC)
Entity Type:Individual
Prefix:DR
First Name:KY
Middle Name:
Last Name:CHUNG
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 1:2527 STONEWOOD ESTATES LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-8500
Mailing Address - Country:US
Mailing Address - Phone:407-913-7343
Mailing Address - Fax:407-730-3981
Practice Address - Street 1:5275 CURRY FORD RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32812-8741
Practice Address - Country:US
Practice Address - Phone:407-730-3980
Practice Address - Fax:407-730-3981
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9170111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor