Individual
DEMETRIOS AGIS KYDONIEUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
435 BUCKHORN DR, BELVIDERE, NJ 07823-2710
(908) 763-1178
(908) 750-4267
Mailing address
8881 SEMINOLE TRL, RUCKERSVILLE, VA 22968-3448
(434) 481-2012
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00566000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58-1893942
FEDERAL TAX ID
NJ
Enumeration date
12/15/2006
Last updated
12/17/2018
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