Provider Demographics
NPI:1831295617
Name:STYNCHULA, LAWRENCE GEORGE (DC)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:GEORGE
Last Name:STYNCHULA
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 1:604 ALWINE CURRY ROAD
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601
Mailing Address - Country:US
Mailing Address - Phone:724-838-0200
Mailing Address - Fax:
Practice Address - Street 1:604 ALWINE CURRY ROAD
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601
Practice Address - Country:US
Practice Address - Phone:724-838-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC002157L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA404711OtherHIGHMARK BCBS
T30199Medicare UPIN
PA404711OtherHIGHMARK BCBS