Provider Demographics
NPI:1962476523
Name:RYWALSKI, DANIELLE MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:MARIE
Last Name:RYWALSKI
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 1:1234 RIDGEWOOD DR STE D
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-2695
Mailing Address - Country:US
Mailing Address - Phone:419-352-0914
Mailing Address - Fax:419-754-2361
Practice Address - Street 1:1234 RIDGEWOOD DR STE D
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-2695
Practice Address - Country:US
Practice Address - Phone:419-352-0914
Practice Address - Fax:197-542-3614
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-13
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2905111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000225962OtherANTHEM
OH2215267Medicaid
OHNA0896051Medicare ID - Type Unspecified
OH2215267Medicaid