Provider Demographics
NPI:1609978378
Name:CHELENYAK, PATRICIA LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:LYNN
Last Name:CHELENYAK
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23975 NOVI RD
Mailing Address - Street 2:SUITE A-101
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-2459
Mailing Address - Country:US
Mailing Address - Phone:248-380-9444
Mailing Address - Fax:248-380-0236
Practice Address - Street 1:23975 NOVI RD
Practice Address - Street 2:SUITE A-101
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-2459
Practice Address - Country:US
Practice Address - Phone:248-380-9444
Practice Address - Fax:248-380-0236
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301004674111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0F35306Medicare ID - Type Unspecified