Provider Demographics
NPI:1942203831
Name:KORZI, CAROL ANN (DC)
Entity type:Individual
Prefix:DR
First Name:CAROL
Middle Name:ANN
Last Name:KORZI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3681 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:WEIRTON
Mailing Address - State:WV
Mailing Address - Zip Code:26062-4049
Mailing Address - Country:US
Mailing Address - Phone:304-723-3330
Mailing Address - Fax:304-723-3336
Practice Address - Street 1:3681 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062-4049
Practice Address - Country:US
Practice Address - Phone:304-723-3330
Practice Address - Fax:304-723-3336
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-24
Last Update Date:2007-07-08
Deactivation Date:2006-03-16
Deactivation Code:
Reactivation Date:2006-03-31
Provider Licenses
StateLicense IDTaxonomies
WV522111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0131508000Medicaid
WV0647852Medicare ID - Type Unspecified
WVU09403Medicare UPIN