Provider Demographics
NPI:1750499505
Name:HORNBECK, CHAD JOSEPH (DC)
Entity type:Individual
Prefix:
First Name:CHAD
Middle Name:JOSEPH
Last Name:HORNBECK
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 1:337 PRINCE ST
Mailing Address - Street 2:
Mailing Address - City:BORDENTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08505-1752
Mailing Address - Country:US
Mailing Address - Phone:609-291-9770
Mailing Address - Fax:
Practice Address - Street 1:1609 WOODBOURNE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19057-1500
Practice Address - Country:US
Practice Address - Phone:215-945-8090
Practice Address - Fax:215-945-2245
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00566200111N00000X
PADC007766L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor