Provider Demographics
NPI:1447694443
Name:HANCZARYK CHIROPRACTIC NEUROLOGY GROUP
Entity type:Organization
Organization Name:HANCZARYK CHIROPRACTIC NEUROLOGY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:HANCZARYK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:810-584-7170
Mailing Address - Street 1:8185 HOLLY RD STE 14
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-2444
Mailing Address - Country:US
Mailing Address - Phone:810-584-7170
Mailing Address - Fax:
Practice Address - Street 1:8185 HOLLY RD STE 14
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-2444
Practice Address - Country:US
Practice Address - Phone:810-584-7170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRISTOL CHIROPRACTIC CENTRE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-04-20
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MICH008867111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0B55055Medicare PIN