Provider Demographics
NPI:1083785414
Name:STYBA, DONALD J (DC)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:J
Last Name:STYBA
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 1:101 KINGS LYNN ROAD
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:WI
Mailing Address - Zip Code:53589-1999
Mailing Address - Country:US
Mailing Address - Phone:608-873-9311
Mailing Address - Fax:
Practice Address - Street 1:101 KINGS LYNN ROAD
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:WI
Practice Address - Zip Code:53589-1999
Practice Address - Country:US
Practice Address - Phone:608-873-9311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1230012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor