Organization
PENCZAK FAMILY CHIROPRACTIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN PENCZAK D.C. (OWNER)
(732) 974-7022
Entity
Organization
Contact information
Practice address
2041 ROUTE 35, WALL, NJ 07719
(732) 974-7022
(732) 974-7023
Mailing address
2041 ROUTE 35, WALL, NJ 07719
(732) 974-7022
(732) 974-7023
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00554100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2273901000
AMERIHEALTH PPO PIN
NJ
Enumeration date
12/06/2006
Last updated
03/17/2008
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