Provider Demographics
NPI:1982835864
Name:OSSIPINSKY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:OSSIPINSKY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:OSSIPINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:480-580-0045
Mailing Address - Street 1:5973 W SACK DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-7612
Mailing Address - Country:US
Mailing Address - Phone:480-580-0045
Mailing Address - Fax:
Practice Address - Street 1:9794 W PEORIA AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85345-6138
Practice Address - Country:US
Practice Address - Phone:480-580-0045
Practice Address - Fax:623-594-8700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-27
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ131824Medicare PIN