Healthcare Provider Details

I. General information

NPI: 1700925815
Provider Name (Legal Business Name): CHRISTOPHER P STYCHNO DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 08/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1553 NILES CORTLAND RD SE STE 1
WARREN OH
44484-3073
US

IV. Provider business mailing address

1553 NILES CORTLAND RD SE STE 1
WARREN OH
44484-3073
US

V. Phone/Fax

Practice location:
  • Phone: 330-372-2324
  • Fax: 330-372-2309
Mailing address:
  • Phone: 330-372-2324
  • Fax: 330-372-2309

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2393
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code111NN0400X
TaxonomyNeurology Chiropractor
License Number6393
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number6393
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number6393
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number6393
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: