Provider Demographics
NPI:1821156696
Name:WYRWAS, ANTHONY JAMES (DC DACBSP)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:JAMES
Last Name:WYRWAS
Suffix:
Gender:M
Credentials:DC DACBSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7575 NORTHCLIFF AVENUE
Mailing Address - Street 2:SUITE 405
Mailing Address - City:BROOKLYN
Mailing Address - State:OH
Mailing Address - Zip Code:44144
Mailing Address - Country:US
Mailing Address - Phone:216-830-2225
Mailing Address - Fax:216-830-2228
Practice Address - Street 1:7575 NORTHCLIFF AVENUE
Practice Address - Street 2:SUITE 405
Practice Address - City:BROOKLYN
Practice Address - State:OH
Practice Address - Zip Code:44144
Practice Address - Country:US
Practice Address - Phone:216-830-2225
Practice Address - Fax:216-830-2228
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3287111N00000X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
No111N00000XChiropractic ProvidersChiropractor