Provider Demographics
NPI:1649334020
Name:KRAYNEK, RONALD (DC)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:
Last Name:KRAYNEK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10350 JO ANN LN
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-3867
Mailing Address - Country:US
Mailing Address - Phone:734-459-9280
Mailing Address - Fax:
Practice Address - Street 1:5816 N SHELDON RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-3153
Practice Address - Country:US
Practice Address - Phone:734-451-1225
Practice Address - Fax:734-451-2813
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301002317111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MICH820012OtherM-CARE
MI95OH252520OtherPPO
MIOH252520Medicare ID - Type Unspecified
MICH820012OtherM-CARE