Provider Demographics
NPI:1023395472
Name:SIMINSKI, KRYSTAL RENEE (DC)
Entity Type:Individual
Prefix:DR
First Name:KRYSTAL
Middle Name:RENEE
Last Name:SIMINSKI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-2914
Mailing Address - Country:US
Mailing Address - Phone:989-723-2039
Mailing Address - Fax:989-725-7723
Practice Address - Street 1:210 W MAIN ST
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-2914
Practice Address - Country:US
Practice Address - Phone:989-723-2039
Practice Address - Fax:989-725-7723
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009758111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor