Healthcare Provider Details

I. General information

NPI: 1164356069
Provider Name (Legal Business Name): PAUL KOMINSKY DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 214
GLEN JEAN WV
25846-0214
US

IV. Provider business mailing address

PO BOX 214
GLEN JEAN WV
25846-0214
US

V. Phone/Fax

Practice location:
  • Phone: 304-465-0909
  • Fax:
Mailing address:
  • Phone: 304-465-0909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number408
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: