Provider Demographics
NPI:1831101054
Name:TOMASZYCKI, PAMELA LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:LYNN
Last Name:TOMASZYCKI
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 1:51060 HAYES RD
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48042-4057
Mailing Address - Country:US
Mailing Address - Phone:586-781-4314
Mailing Address - Fax:
Practice Address - Street 1:51060 HAYES RD
Practice Address - Street 2:
Practice Address - City:MACOMB
Practice Address - State:MI
Practice Address - Zip Code:48042-4057
Practice Address - Country:US
Practice Address - Phone:586-781-4314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008387111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P35530Medicare ID - Type Unspecified