Provider Demographics
NPI:1790820850
Name:PIERZCHALA, GEORGINA LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:GEORGINA
Middle Name:LYNN
Last Name:PIERZCHALA
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 1:7053 W CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43617-1114
Mailing Address - Country:US
Mailing Address - Phone:419-843-1370
Mailing Address - Fax:
Practice Address - Street 1:3218 SECOR RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-1515
Practice Address - Country:US
Practice Address - Phone:419-535-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1387111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP14032141Medicaid
OH9378921Medicare PIN
OH4032142Medicare PIN
OHU28416Medicare UPIN