Provider Demographics
NPI:1821170697
Name:STOREY, DAVID ALLAN (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALLAN
Last Name:STOREY
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 1:5437 MAHONING AVE STE 7
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-2421
Mailing Address - Country:US
Mailing Address - Phone:330-799-5757
Mailing Address - Fax:330-799-5766
Practice Address - Street 1:5437 MAHONING AVE STE 7
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515
Practice Address - Country:US
Practice Address - Phone:330-799-5757
Practice Address - Fax:330-799-5766
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2273111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH025071Medicaid
OH025071Medicaid
OHU54054Medicare UPIN