Provider Demographics
NPI:1336739770
Name:IZYK, CHASE (DC)
Entity Type:Individual
Prefix:DR
First Name:CHASE
Middle Name:
Last Name:IZYK
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 1:113 W ALBANY ST
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-2410
Mailing Address - Country:US
Mailing Address - Phone:315-326-0440
Mailing Address - Fax:
Practice Address - Street 1:113 W ALBANY ST
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-2410
Practice Address - Country:US
Practice Address - Phone:315-326-0440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013429111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor