Provider Demographics
NPI:1699002303
Name:SKRZYNECKI CHIROPRACTIC
Entity Type:Organization
Organization Name:SKRZYNECKI CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SKZYNECKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:419-842-1235
Mailing Address - Street 1:5201 MONROE ST
Mailing Address - Street 2:SUITE 8
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-3197
Mailing Address - Country:US
Mailing Address - Phone:419-842-1235
Mailing Address - Fax:419-842-1189
Practice Address - Street 1:5201 MONROE ST
Practice Address - Street 2:SUITE 8
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-3197
Practice Address - Country:US
Practice Address - Phone:419-842-1235
Practice Address - Fax:419-842-1189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-17
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1130261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2046422Medicaid
1447315114OtherNPI TYPE 1
1447315114OtherNPI TYPE 1
OHU68749Medicare UPIN