Provider Demographics
NPI:1245459825
Name:GEORGE J. POLOCHICK D.C.P.C.
Entity type:Organization
Organization Name:GEORGE J. POLOCHICK D.C.P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:J
Authorized Official - Last Name:POLOCHICK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:508-995-3428
Mailing Address - Street 1:2090 ACUSHNET AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02745-6310
Mailing Address - Country:US
Mailing Address - Phone:508-995-3428
Mailing Address - Fax:508-998-7262
Practice Address - Street 1:2090 ACUSHNET AVE
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02745-6310
Practice Address - Country:US
Practice Address - Phone:508-995-3428
Practice Address - Fax:508-998-7262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty