Provider Demographics
NPI:1457531055
Name:STRYKUL, REGINA LORENE
Entity Type:Individual
Prefix:MS
First Name:REGINA
Middle Name:LORENE
Last Name:STRYKUL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9585 DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:OH
Mailing Address - Zip Code:45817-8503
Mailing Address - Country:US
Mailing Address - Phone:419-369-4091
Mailing Address - Fax:
Practice Address - Street 1:9585 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:OH
Practice Address - Zip Code:45817-8503
Practice Address - Country:US
Practice Address - Phone:419-369-4091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-12
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03608174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist