Healthcare Provider Details

I. General information

NPI: 1497094361
Provider Name (Legal Business Name): CHRIS STYCHNO CHIROPRACTIC CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2013
Last Update Date: 04/06/2020
Certification Date: 04/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 E MARKET ST STE 310
WARREN OH
44481-1151
US

IV. Provider business mailing address

716 PERKINSWOOD BLVD SE
WARREN OH
44483-6228
US

V. Phone/Fax

Practice location:
  • Phone: 234-223-2921
  • Fax: 234-223-2258
Mailing address:
  • Phone: 309-802-1783
  • Fax: 234-223-2258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER P STYCHNO
Title or Position: OWNER/SOLE MBR
Credential: DC
Phone: 234-223-2921