Provider Demographics
NPI:1700925815
Name:STYCHNO, CHRISTOPHER P (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:P
Last Name:STYCHNO
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 1:1553 NILES CORTLAND RD SE STE 1
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-3073
Mailing Address - Country:US
Mailing Address - Phone:330-372-2324
Mailing Address - Fax:330-372-2309
Practice Address - Street 1:1553 NILES CORTLAND RD SE STE 1
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-3073
Practice Address - Country:US
Practice Address - Phone:330-372-2324
Practice Address - Fax:330-372-2309
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2393111N00000X
OH6393111NN0400X, 111NN1001X, 111NR0400X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN0400XChiropractic ProvidersChiropractorNeurology
No111NN1001XChiropractic ProvidersChiropractorNutrition
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2013412Medicaid
OH$$$$$$$$$-00OtherOHIO BWC
OH$$$$$$$$$-00OtherOHIO BWC
OH2013412Medicaid