Provider Demographics
NPI:1902941313
Name:BIZJAK, PAUL WILLIAM (DC)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:WILLIAM
Last Name:BIZJAK
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 1:9630 RAVENNA RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087-6811
Mailing Address - Country:US
Mailing Address - Phone:330-405-2751
Mailing Address - Fax:330-405-2752
Practice Address - Street 1:9630 RAVENNA RD
Practice Address - Street 2:SUITE 100
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-6811
Practice Address - Country:US
Practice Address - Phone:330-405-2751
Practice Address - Fax:330-405-2752
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2523111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH341883685-00OtherBWC
OH341883685-002OtherMEDICAL MUTAUL OF OHIO
OH341883685-00OtherBWC