Provider Demographics
NPI:1780269498
Name:PASTOTNIK, TONI (DC)
Entity type:Individual
Prefix:
First Name:TONI
Middle Name:
Last Name:PASTOTNIK
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 1:16620 NOVAK RD
Mailing Address - Street 2:
Mailing Address - City:EWEN
Mailing Address - State:MI
Mailing Address - Zip Code:49925-9011
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13984 US HIGHWAY 45
Practice Address - Street 2:
Practice Address - City:BRUCE CROSSING
Practice Address - State:MI
Practice Address - Zip Code:49912
Practice Address - Country:US
Practice Address - Phone:906-458-1437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-15
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301401225111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor