Provider Demographics
NPI:1851591143
Name:FAMILY CHIROPRACTIC OFFICE, P.A.
Entity type:Organization
Organization Name:FAMILY CHIROPRACTIC OFFICE, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:CIOLKOSZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:302-993-9113
Mailing Address - Street 1:4748 LIMESTONE RD STE B
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-4387
Mailing Address - Country:US
Mailing Address - Phone:302-993-9113
Mailing Address - Fax:
Practice Address - Street 1:4748 LIMESTONE RD STE B
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-4387
Practice Address - Country:US
Practice Address - Phone:302-993-9113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE424111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty