Provider Demographics
NPI:1760539704
Name:GUZIK, KENNETH LOUIS (DC)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:LOUIS
Last Name:GUZIK
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 1:403 W TEMPERANCE ST
Mailing Address - Street 2:BOX 605
Mailing Address - City:ELLETTSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47429-1431
Mailing Address - Country:US
Mailing Address - Phone:812-876-6847
Mailing Address - Fax:812-876-8135
Practice Address - Street 1:403 W TEMPERANCE ST
Practice Address - Street 2:BOX 605
Practice Address - City:ELLETTSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47429
Practice Address - Country:US
Practice Address - Phone:812-876-6847
Practice Address - Fax:812-876-8135
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08000775A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000210750OtherBC BS
IN350052957OtherRAILROAD MEDICARE
IN350052957OtherRAILROAD MEDICARE
IN184510Medicare ID - Type Unspecified