Provider Demographics
NPI:1407844103
Name:GRYGIER, STEVEN J (DC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:J
Last Name:GRYGIER
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 1:202 WEST PLUM STREET
Mailing Address - Street 2:
Mailing Address - City:EDINBORO
Mailing Address - State:PA
Mailing Address - Zip Code:16412-2121
Mailing Address - Country:US
Mailing Address - Phone:814-734-7777
Mailing Address - Fax:814-734-3971
Practice Address - Street 1:202 W PLUM ST
Practice Address - Street 2:
Practice Address - City:EDINBORO
Practice Address - State:PA
Practice Address - Zip Code:16412-2121
Practice Address - Country:US
Practice Address - Phone:814-734-7777
Practice Address - Fax:814-734-3971
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009647111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1016629520001Medicaid
PA1016629520001Medicaid