Provider Demographics
NPI:1144353285
Name:PACIOREK ENTERPRISES, LLC.
Entity type:Organization
Organization Name:PACIOREK ENTERPRISES, LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:PACIOREK
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:937-399-1159
Mailing Address - Street 1:427 W HARDING RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45504-1746
Mailing Address - Country:US
Mailing Address - Phone:937-399-1159
Mailing Address - Fax:937-399-1884
Practice Address - Street 1:427 W HARDING RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-1746
Practice Address - Country:US
Practice Address - Phone:937-399-1159
Practice Address - Fax:937-399-1884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3645111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2735759Medicaid
OHPA9367241Medicare PIN