Provider Demographics
NPI:1942315437
Name:KRUMPAK, JAMES J III (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:J
Last Name:KRUMPAK
Suffix:III
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 1:1714 BOARDMAN POLAND RD
Mailing Address - Street 2:#1
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-3906
Mailing Address - Country:US
Mailing Address - Phone:330-757-1151
Mailing Address - Fax:330-757-6687
Practice Address - Street 1:1714 BOARDMAN POLAND RD
Practice Address - Street 2:#1
Practice Address - City:POLAND
Practice Address - State:OH
Practice Address - Zip Code:44514-3906
Practice Address - Country:US
Practice Address - Phone:330-757-1151
Practice Address - Fax:330-757-6687
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH944111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHKR0523821Medicare ID - Type UnspecifiedMEDICARE