Provider Demographics
NPI:1124604327
Name:CHASE E. IZYK, DC PC
Entity Type:Organization
Organization Name:CHASE E. IZYK, DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHASE
Authorized Official - Middle Name:E
Authorized Official - Last Name:IZYK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:315-326-0440
Mailing Address - Street 1:113 W ALBANY ST
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-2410
Mailing Address - Country:US
Mailing Address - Phone:315-326-0440
Mailing Address - Fax:315-291-8062
Practice Address - Street 1:113 W ALBANY ST
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-2410
Practice Address - Country:US
Practice Address - Phone:315-326-0440
Practice Address - Fax:315-291-8062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-19
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty