Provider Demographics
NPI:1700037280
Name:SENZ, MISTY LYNN (DC)
Entity Type:Individual
Prefix:
First Name:MISTY
Middle Name:LYNN
Last Name:SENZ
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 1:3759 CENTER RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:PERRY
Mailing Address - State:OH
Mailing Address - Zip Code:44081-9420
Mailing Address - Country:US
Mailing Address - Phone:440-259-1064
Mailing Address - Fax:440-259-1065
Practice Address - Street 1:3759 CENTER RD
Practice Address - Street 2:SUITE G
Practice Address - City:PERRY
Practice Address - State:OH
Practice Address - Zip Code:44081-9420
Practice Address - Country:US
Practice Address - Phone:440-259-1064
Practice Address - Fax:440-259-1065
Is Sole Proprietor?:No
Enumeration Date:2008-10-02
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2560111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2372605Medicaid
OH2372605Medicaid