Provider Demographics
NPI:1376693663
Name:PLUZNYK, WALTER (DC)
Entity Type:Individual
Prefix:DR
First Name:WALTER
Middle Name:
Last Name:PLUZNYK
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 1:2004 E BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37804-3033
Mailing Address - Country:US
Mailing Address - Phone:865-982-4301
Mailing Address - Fax:865-982-4302
Practice Address - Street 1:2004 E BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37804-3033
Practice Address - Country:US
Practice Address - Phone:865-982-4301
Practice Address - Fax:865-982-4302
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000001181111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor