Provider Demographics
NPI:1447326376
Name:SIKORA CHIROPRACTIC AND NUTRITION, LLC
Entity type:Organization
Organization Name:SIKORA CHIROPRACTIC AND NUTRITION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:SIKORA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:330-479-9345
Mailing Address - Street 1:4310 AVONDALE LN NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-1670
Mailing Address - Country:US
Mailing Address - Phone:330-479-9345
Mailing Address - Fax:888-892-8335
Practice Address - Street 1:4310 AVONDALE LN NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-1670
Practice Address - Country:US
Practice Address - Phone:330-479-9345
Practice Address - Fax:888-892-8335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3528111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSI9353551Medicare ID - Type Unspecified