Provider Demographics
NPI:1164610051
Name:BURIK CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:BURIK CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BURIK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:330-627-7112
Mailing Address - Street 1:1244 CANTON RD NW
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:OH
Mailing Address - Zip Code:44615-9453
Mailing Address - Country:US
Mailing Address - Phone:330-627-7112
Mailing Address - Fax:330-627-3876
Practice Address - Street 1:1244 CANTON RD NW
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:OH
Practice Address - Zip Code:44615-9453
Practice Address - Country:US
Practice Address - Phone:330-627-7112
Practice Address - Fax:330-627-3876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-04
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1839111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHU37177Medicaid
000000187268OtherANTHEM OF OHIO
U37177OtherUPIN
BU4039821OtherMEDICARE (OHIO)